Sec Form 4 Filing - Bertolini Mark T @ CVS HEALTH Corp - 2018-12-20

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Bertolini Mark T
2. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [ CVS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
ONE CVS DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
12/20/2018
(Street)
WOONSOCKET, RI02895
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 12/20/2018 J V 89,726( 1 ) D $ 67.2635 0 I By 2017 GRAT( 2 )
Common Stock 12/20/2018 J V 89,726( 1 ) A $ 67.2635 232,711 D
Common Stock 12/20/2018 J V 90,127( 3 ) D $ 67.2635 0 I By 2017 GRAT II( 4 )
Common Stock 12/20/2018 J V 90,127( 3 ) A $ 67.2635 322,838 D
Common Stock 12/20/2018 J V 217,802( 5 ) D $ 67.2635 0 I By 2018 GRAT( 6 )
Common Stock 12/20/2018 J V 217,802( 5 ) A $ 67.2635 540,640 D
Common Stock 12/20/2018 J V 112,808( 7 ) D $ 67.2635 0 I By 2016 Trust( 8 )
Common Stock 12/20/2018 J V 112,808( 7 ) A $ 67.2635 653,448 D
Common Stock 12/20/2018 J V 12,534( 9 ) D $ 67.2635 0 I By 2018 Trust( 10 )
Common Stock 12/20/2018 J V 12,534( 9 ) A $ 67.2635 665,982 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Bertolini Mark T
ONE CVS DRIVE
WOONSOCKET, RI02895
X
Signatures
/s/ Mark T. Bertolini 12/26/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares 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.
( 2 )Represents shares held by a 2017 GRAT for which the reporting person is the sole trustee.
( 3 )Shares 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.
( 4 )Represents shares held by a 2017 GRAT II for which the reporting person is the sole trustee.
( 5 )Shares 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.
( 6 )Represents shares held by a 2018 GRAT for which the reporting person is the sole trustee.
( 7 )Shares 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.
( 8 )Represents shares held by a 2016 Trust for which the reporting person is the investment advisor.
( 9 )Shares 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.
( 10 )Represents shares held by a 2018 Trust for which the reporting person is the investment advisor.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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