0000899243-16-015434.txt : 20160307 0000899243-16-015434.hdr.sgml : 20160307 20160307181426 ACCESSION NUMBER: 0000899243-16-015434 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160303 FILED AS OF DATE: 20160307 DATE AS OF CHANGE: 20160307 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: 1200 LAKESIDE DRIVE CITY: BANNOCKBURN STATE: IL ZIP: 60015 BUSINESS PHONE: 224-940-2000 MAIL ADDRESS: STREET 1: 1200 LAKESIDE DRIVE CITY: BANNOCKBURN 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: 161489797 MAIL ADDRESS: STREET 1: C/O BAXALTA INCORPORATED STREET 2: 1200 LAKESIDE DRIVE CITY: BANNOCKBURN STATE: IL ZIP: 60015 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-03-03 0 0001620546 Baxalta Inc BXLT 0001496182 HOMBACH ROBERT J. C/O BAXALTA INCORPORATED 1200 LAKESIDE DRIVE BANNOCKBURN IL 60015 0 1 0 0 EVP, CFO and COO Common Stock, par value $0.01 per share 2016-03-03 4 A 0 81384 A 198364 D Common Stock, par value $0.01 per share 2016-03-03 4 F 0 5900 39.30 D 192464 D The reporting person received a grant of 81,384 restricted stock units which will vest in three equal installments beginning on the first anniversary of the grant date. Represents the number of shares forfeited by the reporting person to cover the payment of taxes incurred as a result of partial vesting of restricted stock granted on March 3, 2015. /s/ Stephanie D. Miller, as attorney-in-fact for Robert J. Hombach 2016-03-07