0001209191-12-048795.txt : 20121009 0001209191-12-048795.hdr.sgml : 20121008 20121009182830 ACCESSION NUMBER: 0001209191-12-048795 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120902 FILED AS OF DATE: 20121009 DATE AS OF CHANGE: 20121009 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROTMAN JEFFREY H CENTRAL INDEX KEY: 0001184491 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20355 FILM NUMBER: 121136146 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: 0902 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 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2012-09-02 0 0 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 2011-11-14 5 G 0 25000 D 134893 D Common Stock 2011-12-30 5 G 0 8500 D 86495 D Common Stock 626703.04 I 1984 Brotman Family Trust Common Stock 20 I Justin Brotman Personal gift. 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 2012-10-09