SEC Form 4 · accession 0001127602-16-066162
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
C David Brown II
Director
Period of report
Nov 2, 2016
Accepted (ET)
Nov 4, 2016 · 4:16 pm EDT
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 Stock | holding | — | — | — | 91,252 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Share CreditsF1,F2 | $0.00 | Nov 2, 2016 | A | 1,787 | A | — | — | Common Stock | 1,787 | 48,020 | D |
Explanation of responses
- F1Consists of share credits issued for deferral of a semi-annual retainer, at the market price, pursuant to the 2010 Incentive Compensation Plan.
- F2Consists of deferred stock compensation payable pursuant to Reporting Person's election.