0001209191-12-057547.txt : 20121213 0001209191-12-057547.hdr.sgml : 20121213 20121213183520 ACCESSION NUMBER: 0001209191-12-057547 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121212 FILED AS OF DATE: 20121213 DATE AS OF CHANGE: 20121213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOULTON PAUL G CENTRAL INDEX KEY: 0001184501 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20355 FILM NUMBER: 121263290 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-12-12 0 0000909832 COSTCO WHOLESALE CORP /NEW COST 0001184501 MOULTON PAUL G 999 LAKE DRIVE ISSAQUAH WA 98027 0 1 0 0 Executive VP Common Stock 2012-12-12 4 A 0 2541 98.31 A 56434 D Common Stock 9925 I Moulton Revocable Trust Represents additional restricted stock units ("RSUs") resulting from the upward adjustment of outstanding unvested RSUs by a factor of 1.0763 in connection with the $7.00 per share special cash dividend payable by the issuer to shareholders of record on December 10, 2012. The adjustment was required under the plan documents governing the grants. The RSUs reported are subject to the same vesting schedules as the original RSUs to which they relate. Deanna K. Nakashima, attorney-in-fact 2012-12-13