SEC Form 4 · accession 0001127602-18-037330
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark T Bertolini
Director
Period of report
Dec 20, 2018
Accepted (ET)
Dec 26, 2018 · 4:10 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,F2 | Dec 20, 2018 | J | 89,726 | $67.2635 | D | 0 | I | By 2017 GRAT |
| Common StockF1 | Dec 20, 2018 | J | 89,726 | $67.2635 | A | 232,711 | D | |
| Common StockF3,F4 | Dec 20, 2018 | J | 90,127 | $67.2635 | D | 0 | I | By 2017 GRAT II |
| Common StockF3 | Dec 20, 2018 | J | 90,127 | $67.2635 | A | 322,838 | D | |
| Common StockF5,F6 | Dec 20, 2018 | J | 217,802 | $67.2635 | D | 0 | I | By 2018 GRAT |
| Common StockF5 | Dec 20, 2018 | J | 217,802 | $67.2635 | A | 540,640 | D | |
| Common StockF7,F8 | Dec 20, 2018 | J | 112,808 | $67.2635 | D | 0 | I | By 2016 Trust |
| Common StockF7 | Dec 20, 2018 | J | 112,808 | $67.2635 | A | 653,448 | D | |
| Common StockF9,F10 | Dec 20, 2018 | J | 12,534 | $67.2635 | D | 0 | I | By 2018 Trust |
| Common StockF9 | Dec 20, 2018 | J | 12,534 | $67.2635 | A | 665,982 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Shares that the Reporting Person previously reported as indirectly owned through a 2017 Grantor Retained Annuity Trust ("GRAT") were transferred to the Reporting Person's personal brokerage account on December 20, 2018.
- F10Represents shares held by a 2018 Trust for which the reporting person is the investment advisor.
- F2Represents shares held by a 2017 GRAT for which the reporting person is the sole trustee.
- F3Shares that the Reporting Person previously reported as indirectly owned through a 2017 GRAT II were transferred to the Reporting Person's personal brokerage account on December 20, 2018.
- F4Represents shares held by a 2017 GRAT II for which the reporting person is the sole trustee.
- F5Shares that the Reporting Person previously reported as indirectly owned through a 2018 GRAT were transferred to the Reporting Person's personal brokerage account on December 20, 2018.
- F6Represents shares held by a 2018 GRAT for which the reporting person is the sole trustee.
- F7Shares that the Reporting Person previously reported as indirectly owned through a 2016 Trust were transferred to the Reporting Person's personal brokerage account on December 20, 2018.
- F8Represents shares held by a 2016 Trust for which the reporting person is the investment advisor.
- F9Shares that the Reporting Person previously reported as indirectly owned through a 2018 Trust were transferred to the Reporting Person's personal brokerage account on December 20, 2018.