-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KI3DLazCWp7FE4We/4U+DiGIhYD1xvO1yIp7tj086bJqOpKI1EHwNXb6Ez4kTFqY ctjR2bjXMmlh5FSsaF3hcA== 0001184948-03-000003.txt : 20031119 0001184948-03-000003.hdr.sgml : 20031119 20031119164444 ACCESSION NUMBER: 0001184948-03-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031119 FILED AS OF DATE: 20031119 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SINEGAL JAMES D CENTRAL INDEX KEY: 0001184948 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 333-82782 FILM NUMBER: 031013332 MAIL ADDRESS: STREET 1: C/O COSTCO WHOLESALE CORP. STREET 2: 999 LAKE DRIVE CITY: ISAQUAH STATE: WA ZIP: 98027 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COSTCO WHOLESALE CORP /NEW CENTRAL INDEX KEY: 0000909832 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-VARIETY STORES [5331] IRS NUMBER: 911223280 STATE OF INCORPORATION: WA FISCAL YEAR END: 0830 BUSINESS ADDRESS: STREET 1: 999 LAKE DRIVE CITY: ISSAQUAH STATE: WA ZIP: 98027- BUSINESS PHONE: 4253138100 MAIL ADDRESS: STREET 1: 999 LAKE DRIVE CITY: ISSAQUAH STATE: WA ZIP: 98027 FORMER COMPANY: FORMER CONFORMED NAME: COSTCO COMPANIES INC DATE OF NAME CHANGE: 19970401 FORMER COMPANY: FORMER CONFORMED NAME: PRICE/COSTCO INC DATE OF NAME CHANGE: 19930728 4 1 primary_doc.xml PRIMARY DOCUMENT X0201 4 2003-11-19 0 0000909832 COSTCO WHOLESALE CORP /NEW COST 0001184948 SINEGAL JAMES D C/O COSTCO WHOLESALE CORP. 999 LAKE DRIVE ISAQUAH WA 98027 1 1 0 0 President and CEO Common Stock 2003-11-19 4 C 0 450000 D 3278402 D Prepaid Variable Share Forward 2003-11-19 4 C 0 450000 D 2003-11-19 2003-11-19 Common Stock 450000 0 D The reporting person entered into a pre-paid variable share forward contract on November 19, 2001 relating to 450,000 shares of Costco Wholesale Corporation common stock. In exchange for cash in the amount of $15,640,442.19, the reporting person agreed to deliver 450,000 shares of Common Stock on November 19, 2003 (or on an earlier date if the contract is terminated early) if the price of Common Stock on that day is less than $42.667. On November 19, 2003, the reporting person delivered 450,000 shares in settlement of the contract. James D. Sinegal 2003-11-19 -----END PRIVACY-ENHANCED MESSAGE-----