0001209191-12-057555.txt : 20121213 0001209191-12-057555.hdr.sgml : 20121213 20121213183726 ACCESSION NUMBER: 0001209191-12-057555 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: RUCKELSHAUS JILL S CENTRAL INDEX KEY: 0001228938 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20355 FILM NUMBER: 121263302 MAIL ADDRESS: STREET 1: 1015 EVERGREEN POINT RD CITY: MEDINA STATE: WA ZIP: 98039 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 0001228938 RUCKELSHAUS JILL S P.O. BOX 76 MEDINA WA 98039 1 0 0 0 Common Stock 2012-12-12 4 A 0 456 98.31 A 25022 D Stock Option 34.71 2012-12-12 4 A 0 12915 34.71 A 2004-04-01 2014-04-01 Common Stock 12915 12915 D Stock Option 40.69 2012-12-12 4 A 0 12915 40.69 A 2005-04-01 2015-04-01 Common Stock 12915 12915 D 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. This option was previously reported as an option covering 12,000 shares at an exercise price of $37.35 per share and has been adjusted with a lower exercise price and an increased number of options, in connection with the dividend referenced in note 1. The number of outstanding options was increased by a factor of 1.0763, and the option exercise price was reduced by dividing the price by that same factor. The adjustment was required under the governing plan documents. This option is fully vested. This option was previously reported as an option covering 12,000 shares at an exercise price of $43.79 per share and has been adjusted with a lower exercise price and an increased number of options, in connection with the dividend referenced in note 1. The number of outstanding options was increased by a factor of 1.0763, and the option exercise price was reduced by dividing the price by that same factor. The adjustment was required under the governing plan documents. Deanna K. Nakashima, attorney-in-fact 2012-12-13