0000059478-22-000065.txt : 20220217 0000059478-22-000065.hdr.sgml : 20220217 20220217164449 ACCESSION NUMBER: 0000059478-22-000065 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220216 FILED AS OF DATE: 20220217 DATE AS OF CHANGE: 20220217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Van Naarden Jacob CENTRAL INDEX KEY: 0001661254 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-06351 FILM NUMBER: 22648831 MAIL ADDRESS: STREET 1: C/O ELI LILLY & CO STREET 2: LILLY CORPORATE CENTER CITY: INDIANAPOLIS STATE: IN ZIP: 46285 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ELI LILLY & Co CENTRAL INDEX KEY: 0000059478 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 350470950 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: LILLY CORPORATE CTR STREET 2: DROP CODE 1094 CITY: INDIANAPOLIS STATE: IN ZIP: 46285 BUSINESS PHONE: 3172762000 MAIL ADDRESS: STREET 1: LILLY CORPORATE CENTER STREET 2: DROP CODE 1094 CITY: INDIANAPOLIS STATE: IN ZIP: 46285 FORMER COMPANY: FORMER CONFORMED NAME: LILLY ELI & CO DATE OF NAME CHANGE: 19941024 4 1 wf-form4_164513426243246.xml FORM 4 X0306 4 2022-02-16 0 0000059478 ELI LILLY & Co LLY 0001661254 Van Naarden Jacob LILLY CORPORATE CENTER INDIANAPOLIS IN 46285 0 1 0 0 SVP, CEO LoxoONC, Pres LlyONC Common Stock 2022-02-16 4 M 0 5461 0 A 10153 D Common Stock 2022-02-16 4 F 0 2186 243.84 D 7967 D Common Stock 4342 I Van Naarden Family Trust Restricted Stock Unit 2022-02-16 4 M 0 5461 0 D 2022-02-16 2022-02-16 Common Stock 5461.0 0 D The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that the reporting person is the beneficial owner of the reported securities for purposes of Section 16 or for any other purpose. Each restricted stock unit represents a contingent right to receive one share of Eli Lilly and Company common stock. /s/ Jonathan Groff for Jacob Van Naarden, authorization on file 2022-02-17