0001209191-11-056019.txt : 20111115 0001209191-11-056019.hdr.sgml : 20111115 20111115125859 ACCESSION NUMBER: 0001209191-11-056019 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111104 FILED AS OF DATE: 20111115 DATE AS OF CHANGE: 20111115 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROTMAN JEFFREY H CENTRAL INDEX KEY: 0001184491 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20355 FILM NUMBER: 111206447 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: 0828 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 doc4.xml FORM 4 SUBMISSION X0304 4 2011-11-04 0 0000909832 COSTCO WHOLESALE CORP /NEW COST 0001184491 BROTMAN JEFFREY H 999 LAKE DRIVE ISSAQUAH WA 98027 1 1 0 0 Chairman of the Board Common Stock 2011-11-04 4 J 0 50000 83.71 A 159893 D Common Stock 2011-11-04 4 J 0 50000 D 686703.04 I 1984 Brotman Family Trust Common Stock 20 I Justin Brotman On the date reported, Mr. Brotman received a distribution of 50,000 shares from the 1984 Brotman Family Trust. The price is the closing price that day. Mr. Brotman disclaims beneficial ownership of shares owned by the trust. Mr. Brotman is not a trustee of this trust nor does he have investment control over the trust's assets. Mr. Brotman is one of a number of beneficiaries of the trust. Deanna K. Nakashima, attorney-in-fact 2011-11-15