SEC Form 4 · accession 0000059478-17-000074
ELI LILLY & Co · LLY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Susan Mahony
Officer — SVP & Pres., Lilly Oncology
Period of report
Feb 1, 2017
Accepted (ET)
Feb 3, 2017 · 3:08 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 | Feb 1, 2017 | M | 9,732 | $0.00 | A | 96,040 | D | |
| Common Stock | Feb 1, 2017 | F | 4,570 | $77.03 | D | 91,470 | D | |
| Common Stock | holding | — | — | — | 1,684 | I | 401(k) | |
| Common StockF1 | holding | — | — | — | 1,673 | I | 401(k) - by husband | |
| Common StockF1 | holding | — | — | — | 13,509 | I | by husband |
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 | — | Feb 1, 2017 | M | 9,732 | D | Feb 1, 2017 | Feb 1, 2017 | Common Stock | 9,732 | 0 | 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.