0000899243-15-000629.txt : 20150706
0000899243-15-000629.hdr.sgml : 20150703
20150706203839
ACCESSION NUMBER: 0000899243-15-000629
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150701
FILED AS OF DATE: 20150706
DATE AS OF CHANGE: 20150706
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Baxalta Inc
CENTRAL INDEX KEY: 0001620546
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 471869689
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: ONE BAXTER PARKWAY
CITY: DEERFIELD
STATE: IL
ZIP: 60015
BUSINESS PHONE: 224-948-2000
MAIL ADDRESS:
STREET 1: ONE BAXTER PARKWAY
CITY: DEERFIELD
STATE: IL
ZIP: 60015
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HOMBACH ROBERT J.
CENTRAL INDEX KEY: 0001496182
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36782
FILM NUMBER: 15975051
MAIL ADDRESS:
STREET 1: ONE BAXTER PARKWAY, BUILDING 1
CITY: DEERFIELD
STATE: IL
ZIP: 60015
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2015-07-01
0
0001620546
Baxalta Inc
BXLT
0001496182
HOMBACH ROBERT J.
C/O BAXALTA INCORPORATED
ONE BAXTER PARKWAY
DEERFIELD
IL
60015
0
1
0
0
EVP, CFO and COO
Common Stock, par value $0.01 per share
2015-07-01
4
J
0
22568
0.00
A
22568
D
Common Stock, par value $0.01 per share
2015-07-01
4
J
0
88989
0.00
A
111557
D
Stock Option (Right to Buy)
24.83
2015-07-01
4
J
0
49628
0.00
A
2021-03-04
Common Stock, par value $0.01 per share
49628
49628
D
Stock Option (Right to Buy)
26.53
2015-07-01
4
J
0
88597
0.00
A
2022-03-06
Common Stock, par value $0.01 per share
88597
88597
D
Stock Option (Right to Buy)
32.42
2015-07-01
4
J
0
95163
0.00
A
2023-03-05
Common Stock, par value $0.01 per share
95163
95163
D
Stock Option (Right to Buy)
31.86
2015-07-01
4
J
0
103181
0.00
A
2024-03-04
Common Stock, par value $0.01 per share
103181
103181
D
Stock Option (Right to Buy)
32.04
2015-07-01
4
J
0
287936
0.00
A
2025-03-03
Common Stock, par value $0.01 per share
287936
287936
D
Stock Option (Right to Buy)
31.50
2015-07-01
4
A
0
380535
0.00
A
2025-07-01
Common Stock, par value $0.01 per share
380535
380535
D
Stock Option (Right to Buy)
31.50
2015-07-01
4
A
0
35170
0.00
A
2025-07-01
Common Stock, par value $0.01 per share
35170
35170
D
Represents shares of Baxalta Incorporated ("Baxalta") common stock received in connection with the spin-off (the "Spin-off") of Baxalta from Baxter International Inc. ("Baxter"), in an exempt transaction pursuant to Rule 16a-9. Shares beneficially owned includes shares of common stock for which delivery has been deferred.
Represents restricted stock units granted by Baxalta to the reporting person as a result of the adjustment of existing Baxter restricted stock units held by the reporting person prior to the Spin-off. These restricted stock units vest on the schedule set forth in the original grant agreement.
Represents options to purchase shares of Baxalta common stock granted to the reporting person as a result of adjustments to existing Baxter stock options made in connection with the Spin-Off.
This option is presently exercisable in full.
Two-thirds of this option is presently exercisable. The remaining one third becomes exercisable on March 5, 2016.
One-third of this option is presently exercisable. The remaining two thirds become exercisable on March 4, 2016 and March 4, 2017.
This option will vest in three equal annual installments beginning on March 3, 2016, the first anniversary of the grant date of the existing option award.
This option becomes exercisable in full on the fifth anniversary of the date of the grant.
This option will vest in three equal annual installments beginning on July 1, 2016.
/s/ Stephanie D. Miller, as attorney-in-fact for Robert J. Hombach
2015-07-06