Initial Statement of Beneficial Ownership (3)
2022年1月11日 - 7:14AM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
Shah Prem S |
2. Date of Event Requiring Statement (MM/DD/YYYY)
1/1/2022
|
3. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [CVS]
|
(Last)
(First)
(Middle)
ONE CVS DRIVE |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) EVP and Co-President of Retail / |
(Street)
WOONSOCKET, RI 02895
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Beneficially Owned
|
1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 11980.24 | D | |
Common Stock (restricted) (1) | 575 | D | |
Common Stock (restricted) (2) | 2884 | D | |
Common Stock (restricted) (3) | 15427 | D | |
Common Stock (restricted) (4) | 1808 | D | |
Common Stock (restricted) (5) | 1925 | D | |
Common Stock (restricted) (6) | 6393 | D | |
Common Stock (restricted) (7) | 4372.62 | D | |
Common Stock (restricted) (8) | 2798 | D | |
Stock Unit (deferred) (9) | 5625.28 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (10) | 4/1/2017 | 4/1/2023 | Common Stock | 5870 | $104.82 | D | |
Stock Option (11) | 4/1/2016 | 4/1/2022 | Common Stock | 5346 | $102.26 | D | |
Stock Option (12) | 4/1/2019 | 4/1/2025 | Common Stock | 1691 | $62.2011 | D | |
Stock Option (13) | 4/1/2020 | 4/1/2029 | Common Stock | 12626 | $54.19 | D | |
Stock Option (14) | 4/1/2021 | 4/1/2030 | Common Stock | 34315 | $58.34 | D | |
Stock Option (15) | 4/1/2022 | 4/1/2031 | Common Stock | 32826 | $74.30 | D | |
Stock Option (16) | 8/31/2021 | 8/31/2028 | Common Stock | 26580 | $75.24 | D | |
Explanation of Responses: |
(1) | Consists of remaining Restricted Stock Units (RSUs) awarded pursuant to Issuer's Performance-Based Restricted Stock Plan, a sub-plan under its 2017 Incentive Compensation Plan (ICP). Restrictions lapse on 02/28/2022. |
(2) | Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions on remaining RSUs lapse in two equal installments commencing on 04/01/2022. |
(3) | Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions on remaining RSUs lapse in three equal installments commencing on 04/01/2022. |
(4) | Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions lapse on 04/01/2022. |
(5) | Consists of remaining RSUs awarded pursuant to Issuer's Performance-Based Restricted Stock Plan, a sub-plan under its 2017 ICP. Restrictions lapse in two equal installments commencing on 02/28/2022. |
(6) | Consists of RSUs awarded pursuant to Issuer's 2017 ICP. Restrictions on remaining RSUs lapse in four equal installments commencing on 04/01/2022. |
(7) | Consists of Matching RSUs awarded pursuant to Issuer's Partnership Equity Program, a sub-plan under its ICP, and dividend equivalents on the Matching RSUs. Restrictions lapse on the RSUs on 08/31/2023. |
(8) | Consists of RSUs awarded pursuant to Issuer's Performance-Based Restricted Stock Plan under its 2017 ICP. Restrictions lapse in three equal installments commencing on 02/26/2022. |
(9) | Consists of Stock Units awarded pursuant to Issuer's 2010 & 2017 Incentive Compensation Plans, the receipt of which the reporting person has elected to defer. |
(10) | Option becomes exercisable in four equal installments commencing 04/01/2017. |
(11) | Option becomes exercisable in four equal installments commencing 04/01/2016. |
(12) | Option becomes exercisable in four equal installments commencing 04/01/2019. Additional options from this award have been exercised. |
(13) | Option becomes exercisable in four equal installments commencing 04/01/2020. Additional options from this award have been exercised. |
(14) | Option becomes exercisable in four equal installments commencing 04/01/2021. Additional options from this award have been exercised. |
(15) | Option becomes exercisable in three equal installments commencing 04/01/2022. |
(16) | Option vests in three equal installments, on 8/31/2021, 8/31/2022 and 8/31/2023. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Shah Prem S ONE CVS DRIVE WOONSOCKET, RI 02895 |
|
| EVP and Co-President of Retail |
|
Signatures
|
/s/ Prem S. Shah | | 1/10/2022 |
**Signature of Reporting Person | Date |
CVS Health (NYSE:CVS)
過去 株価チャート
から 3 2024 まで 4 2024
CVS Health (NYSE:CVS)
過去 株価チャート
から 4 2023 まで 4 2024