0001209191-17-035635.txt : 20170525 0001209191-17-035635.hdr.sgml : 20170525 20170525213710 ACCESSION NUMBER: 0001209191-17-035635 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170524 FILED AS OF DATE: 20170525 DATE AS OF CHANGE: 20170525 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 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: 17871564 MAIL ADDRESS: STREET 1: 999 LAKE DRIVE CITY: ISSAQUAH STATE: WA ZIP: 98027 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-05-24 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 2017-05-24 4 A 0 2057 173.01 A 83309 D Common Stock 374495.04 I 1984 Brotman Family Trust Represents additional restricted stock units ("RSUs") resulting from the upward adjustment of outstanding unvested RSUs by a factor of 1.032, in connection with the special cash dividend to be paid by the issuer on May 26, 2017. The adjustment was required under applicable plan documents. The additional RSUs reported are subject to the same vesting schedules as the original unvested RSUs to which they relate. 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 2017-05-25