SEC Form 4 · accession 0001127602-15-030638
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David W Dorman
Director
Period of report
Nov 4, 2015
Accepted (ET)
Nov 6, 2015 · 4:24 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000064803
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 4, 2015 | A | 2,862 | $99.57 | A | 66,469 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Share CreditsF2,F3 | $0.00 | holding | — | — | — | — | — | Common Stock | 15,837 | 15,837 | D |
Explanation of responses
- F1Consists of common stock issued in payment of a semi-annual retainer.
- F2Consists of deferred stock compensation payable pursuant to Reporting Person's election.
- F3Consists of share credits acquired as deferred annual grant, semi-annual compensation and/or meeting fees, all at market price pursuant to the 1997 Incentive Compensation Plan, and payable pursuant to Reporting Person's election.