SEC Form 4 · accession 0001127602-16-066173
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 2, 2016
Accepted (ET)
Nov 4, 2016 · 4:28 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 StockF1 | Nov 2, 2016 | A | 3,394 | $83.95 | A | 72,686 | 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 | $0.00 | holding | — | — | — | — | — | Common Stock | 16,214 | 16,214 | 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.