James David Clark Form 4/A CVS HEALTH / James David Clark ownership change

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

Clark James David

(Last)

(First)

(Middle)

ONE CVS DRIVE

(Street)

WOONSOCKET

02895

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
CVS HEALTH Corp [ CVS ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
SVP, Cont & Chief Acct Officer

3. Date of Earliest Transaction (Month/Day/Year)
12/01/2021

4. If Amendment, Date of Original Filed (Month/Day/Year)
12/03/2021

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock (restricted)	12/01/2021		F⁽¹⁾		266	D	$88.78	16,723	D
Common Stock								17,497.2554	D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Stock Option	$102.26							04/01/2016⁽²⁾	04/01/2022	Common Stock	6,059		6,059	D
Stock Option	$104.82							04/01/2017⁽³⁾	04/01/2023	Common Stock	7,044		7,044	D
Stock Option	$78.05							04/03/2018⁽⁴⁾	04/03/2024	Common Stock	9,050		9,050	D
Stock Option	$62.21							04/01/2019⁽⁵⁾	04/01/2025	Common Stock	7,513		7,513	D
Stock Option	$54.19							04/01/2020⁽⁶⁾	04/01/2029	Common Stock	24,240		24,240	D
Stock Option	$58.34⁽⁷⁾							04/01/2021⁽⁸⁾	04/01/2030	Common Stock	17,157		17,157	D
Stock Option	$74.3							04/01/2022⁽⁹⁾	04/01/2031	Common Stock	12,094		12,094	D
Stock Option	$101.09							04/01/2023⁽¹⁰⁾	04/01/2032	Common Stock	0		0	D

Explanation of Responses:

1. Transaction represents the withholding of shares by the Issuer to satisfy FICA taxes arising from the reporting person being retirement eligible.

2. Options became exercisable in four equal annual installments beginning on 4/1/2016.

3. Options became exercisable in four equal annual installments beginning on 4/1/2017.

4. Options became exercisable in four equal annual installments beginning on 4/3/2018.

5. Options became exercisable in four equal annual installments, commencing 4/1/2019.

6. Options became exercisable in four equal annual installments, commencing 4/1/2020.

7. The number of shares subject to the option were calculated using a 30-day average price.

8. Options became exercisable in four equal annual installments, commencing 4/1/2021.

9. Option becomes exercisable in four equal annual installments, commencing 4/1/2022.

10. Option becomes exercisable in four equal installments, commencing 4/1/2023.

	/s/ James D. Clark	10/13/2022
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.

James David Clark Form 4/ACVS HEALTH / James David Clark ownership change