SEC Form 4 · accession 0000059478-17-000045
ELI LILLY & Co · LLY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Derica W Rice
Officer — EVP-Global Services and CFO
Period of report
Jan 27, 2017
Accepted (ET)
Jan 31, 2017 · 6:18 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000059478
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jan 27, 2017 | A | 38,980 | $75.38 | A | 38,980 | D | |
| Common Stock | holding | — | — | — | 7,396 | I | 401(k) | |
| Common StockF1 | holding | — | — | — | 365,659 | I | by wife | |
| Common StockF1 | holding | — | — | — | 1,905 | I | 401(k) - by wife |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitF2 | — | Jan 27, 2017 | A | 40,518 | A | Feb 1, 2018 | Feb 1, 2018 | Common Stock | 40,518 | 40,518 | D |
Explanation of responses
- F1Reporting person disclaims beneficial ownership of these shares.
- F2Each restricted stock unit represents a contingent right to receive one share of Eli Lilly and Company common stock.