0000014272-17-000187.txt : 20171003 0000014272-17-000187.hdr.sgml : 20171003 20171003165039 ACCESSION NUMBER: 0000014272-17-000187 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170930 FILED AS OF DATE: 20171003 DATE AS OF CHANGE: 20171003 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Samuels Theodore R. II CENTRAL INDEX KEY: 0001688276 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01136 FILM NUMBER: 171118668 MAIL ADDRESS: STREET 1: 1990 E. GRAND AVE. CITY: EL SEGUNDO STATE: CA ZIP: 90245 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BRISTOL MYERS SQUIBB CO CENTRAL INDEX KEY: 0000014272 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 220790350 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 345 PARK AVE CITY: NEW YORK STATE: NY ZIP: 10154 BUSINESS PHONE: 2125464000 MAIL ADDRESS: STREET 1: 345 PARK AVE CITY: NEW YORK STATE: NY ZIP: 10154 FORMER COMPANY: FORMER CONFORMED NAME: BRISTOL MYERS CO DATE OF NAME CHANGE: 19891012 4 1 wf-form4_150706382604179.xml FORM 4 X0306 4 2017-09-30 0 0000014272 BRISTOL MYERS SQUIBB CO BMY 0001688276 Samuels Theodore R. II BRISTOL-MYERS SQUIBB COMPANY 345 PARK AVENUE NEW YORK NY 10154 1 0 0 0 Deferred Share Units 2017-09-30 4 A 0 240.234 63.74 A Common Stock, $0.10 par value 240.234 3566.128 D Each Deferred Share Unit will be converted into a share of common stock upon settlement. The Deferred Share Units become settleable when the reporting person ceases to be a director or at a future date previously specified by the reporting person. /s/ Katherine R. Kelly, attorney-in-fact for Theodore R. Samuels 2017-10-03