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