OCCIDENTAL PETROLEUM CORPORATION
LONG-TERM INCENTIVE GRANT TERMINATION STATUS FORM
Section A This section should be completed by Human Resources prior to the employee’s scheduled termination date for each
terminating employee who has a long-term incentive award (1). After completion, and prior to the scheduled termination date, the form
should be delivered to the Director Compensation.
Name:
EEID:
Title:
Division:
Department:
Grade:
Time in Grade:
Date of Birth:
Date of Hire:
Performance Rating:
Date of Performance
Rating:
Special Circumstances:
Comments:
Last
Day
as
an
Active
Employee: (for severance, last
day of two-month notice period)
Stock Type Checklist Code (i.e.,
checklist code in PeopleSoft):
LTI or STOCK: Awards
other than Phantom Stock
PRPPHM: Phantom Stock awards with prorated payouts upon termination (Check box to
(check box to right if employee has
LTI or STOCK checklist in
PeopleSoft)
right if employee has PRPPHM checklist in PeopleSoft)
Section A Completed By:
Date:
Section B
 HUMAN RESOURCES: Place a check in the box below corresponding to the termination type that you recommend for this
employee, sign and date at the end of this page, and then send this form to the Vice President Compensation & Benefits.
ACTUAL PAYMENT DATE SUBJECT TO IRC § 409A PAYMENT DELAYS FOR SPECIFIED EMPLOYEES.
 VP COMP & BENEFITS: SEND ORIGINAL FORM TO THE EXECUTIVE COMPENSATION DEPARTMENT, HOUSTON, with a
copy to Payroll, the Data Administration Team, Accounting, and the appropriate Human Resources team.
HR
Recommendation
Termination Type(1)
VOLUNTARY TERMINATION (TERVOL)
INVOLUNTARY TERMINATION (TERINV): SEVERANCE/SEPARATION OPTION “A”
INVOLUNTARY TERMINATION (TERINB): SEVERANCE/SEPARATION OPTION “B”
TERMINATION FOR CAUSE (TERCSE)
DISABILITY TERMINATION (TERDIS)
RETIREMENT (TERRET): NORMAL RETIREMENT
RETIREMENT (TERREM): MODIFIED RETIREMENT
DEATH (TERDEA)
HR
Manager (2)
Printed Name:
Signature:
Printed Name:
VP Comp &
Benefits
Date
Darin S. Moss
Signature:
Date
(1)
Impact of termination status on long-term incentive grants applies to regular broad-based grants made in 2001 and thereafter granted
under the Phantom Share Unit Award Plan, the 2005 Long-Term Incentive Plan and/or the 2001 Incentive Compensation Plan.
Consequences for grants prior to 2001, as well as any special grants, may differ.
(2) In most cases, this should be completed by the Director Compensation. In his absence, completion by employee’s HR Manager.
Revised 09_2014
Termination Type(1)
VOLUNTARY TERMINATION (TERVOL)

Options/SARs: forfeiture of unvested shares; vested shares exercisable for lesser of term or three months.

TSRI, RSI, RSIPB, RSITV, ROAI, ROCEI, LTI, PhSU: unvested portion forfeited 100%.
INVOLUNTARY TERMINATION (TERINV): SEVERANCE/SEPARATION OPTION “A”

TSRI, RSI, RSIPB, ROAI, ROCEI: Employee voluntarily forfeits award under 2001 ICP and/or 2005 LTIP and payment
made as follows under the Severance Plan or other separation arrangements: RSI, RSIPB, TSRI - Lump Sum payment
equal to the pro-rata target shares times the closing stock price on the last day of the Notice Period or on the Separation
Date, as applicable; ROAI, ROCEI – equal to the pro-rata target dollars as of the last day of the Notice Period or
Separation Date, as applicable. Resulting payment made as soon as practicable after end of Notice Period or Separation
Date, as applicable. Two-month Notice Period does count toward service.

Options/SARs: forfeiture of unvested shares; vested shares exercisable for lesser of term or three months beginning on
the first day of the Severance Period or the first day after the Separation Date, as applicable.

PhSU, LTI, RSITV: unvested portion forfeited pro-rata and payable immediately.
INVOLUNTARY TERMINATION (TERINB): SEVERANCE/SEPARATION OPTION “B”

TSRI, RSI, RSIPB, ROAI, ROCEI: forfeited pro-rata. Payment to be made after end of performance period in same
manner as payment for actively employed participants.

Options/SARs: forfeiture of unvested shares; vested shares exercisable for lesser of term or three months, beginning on
the first day after the end of Notice Period or Separation Date.

PhSU, LTI, RSITV: unvested portion forfeited pro-rata and payable immediately.
TERMINATION FOR CAUSE (TERCSE)

Options/SARs: forfeiture of vested and unvested shares.

TSRI, RSI, RSIPB, RSITV, ROAI, ROCEI, LTI, PhSU: unvested portion forfeited 100%.
DISABILITY TERMINATION (TERDIS)

Options/SARs: continued vesting; exercisable through term.

TSRI, RSI, RSIPB, ROAI, ROCEI: unvested portion forfeited pro-rata and payable at normally scheduled payment dates.

PhSU, LTI, RSITV: unvested portion forfeited pro-rata and payable immediately.
RETIREMENT (TERRET): NORMAL RETIREMENT

Options/SARs: continued vesting; exercisable through term.

RSI, RSIPB, Pre 2013 or retirement date less than 12 months after Grant Date: TSRI, ROAI, ROCEI: unvested portion
forfeited pro-rata and payable at normally scheduled payment dates.

2013 and later and retirement date 12 months or more after Grant Date: TSRI, ROAI, ROCEI: continued vesting payable
at normally scheduled payment dates.

PhSU, LTI, RSITV: unvested portion forfeited pro-rata and payable immediately.
RETIREMENT (TERREM): MODIFIED RETIREMENT

TSRI, RSI, RSIPB, ROAI, ROCEI: Employee voluntarily forfeits award under 2001 ICP and/or 2005 LTIP and payment
made as follows under the separation arrangement: RSI, RSIPB, TSRI - Lump Sum payment equal to the pro-rata target
shares times the closing stock price on the Separation Date; ROAI, ROCEI – equal to the pro-rata target dollars as of the
Separation Date. Resulting payment made as soon as practicable after Separation Date.

Options/SARs: continued vesting; exercisable through term.

PhSU, LTI, RSITV: unvested portion forfeited pro-rata and payable immediately.
DEATH (TERDEA)

Options/SARs: immediate vesting; exercisable through term.

TSRI, RSI, RSIPB, ROAI, ROCEI: forfeited pro-rata and payable at normally scheduled payment dates.

Pre-2012 LTI, PhSU: immediate vesting and payment.

2012 and later LTI, PhSU, RSITV: unvested portion forfeited pro-rata and payable immediately.
(1) Impact of termination status on long-term incentive grants applies to regular broad-based grants made in 2001 and thereafter
granted under the Phantom Share Unit Plan, the 2005 Long-Term Incentive Plan and/or the 2001 Incentive Compensation Plan.
Consequences for grants prior to 2001, as well as any special grants, may differ.
Revised 09_2014