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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Deferred Comp Plan Baxter Common Stock Fund | (1) | 06/03/2016 | A | 1,114 | (2) | (2) | Common Stock, $1 par value | 1,114 | $ 43.48 | 9,172 | D | ||||
Deferred Comp Plan Baxter Common Stock Fund | (1) | 06/06/2016 | A | 1,312 | (3) | (3) | Common Stock, $1 par value | 1,312 | $ 43.97 | 10,484 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GAVIN JAMES R III ONE BAXTER PARKWAY DEERFIELD, IL 60015 |
X |
/s/ Ellen K. McIntosh, as attorney-in-fact for James R. Gavin III | 06/07/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | 1 for 1. |
(2) | In connection with the June 3, 2016 merger (the "Merger") of a wholly-owned subsidiary of Shire plc with and into Baxalta Incorporated ("Baxalta"), with Baxalta as the surviving company, the reporting person received, or was deemed to receive, cash merger consideration in exchange for Baxalta restricted stock units previously deferred under Baxter's Directors' Deferred Compensation Plan (the "Plan"). A portion of such cash merger consideration was allocated to the Plan's Baxter Common Stock Fund notional investment alternative. |
(3) | On June 6, 2016 and in connection with the Merger, the reporting person received, or was deemed to receive, cash merger consideration with respect to investments previously allocated to the Plan's Baxalta Common Stock Fund notional investment alternative. A portion of such cash merger consideration was allocated to the Plan's Baxter Common Stock Fund notional investment alternative. |