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).
  
 Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
Clark James David
(Last) (First) (Middle)
ONE CVS DRIVE
(Street)
WOONSOCKET RI 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)
11/30/2024
4. If Amendment, Date of Original Filed (Month/Day/Year)
 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)
Code V Amount (A) or (D) Price
Common Stock 11/30/2024 F(1) 86 D $59.85 8,394 D
Common Stock (Restricted) 15,109 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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option $78.05 04/03/2018(2) 04/03/2024 Common Stock 9,050 9,050 D
Stock Option $62.21 04/01/2019(3) 04/01/2025 Common Stock 7,513 7,513 D
Stock Option $54.19 04/01/2020(4) 04/01/2029 Common Stock 24,240 24,240 D
Stock Option $58.34(5) 04/01/2021(6) 04/01/2030 Common Stock 17,157 17,157 D
Stock Option $74.3 04/01/2022(7) 04/01/2031 Common Stock 12,094 12,094 D
Stock Option $101.09 04/01/2023(8) 04/01/2032 Common Stock 6,756 6,756 D
Stock Option(9) $74.31 04/01/2024 04/01/2033 Common Stock 9,649 9,649 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 4/3/2018.
3. Options became exercisable in four equal annual installments, commencing 4/1/2019.
4. Options became exercisable in four equal annual installments, commencing 4/1/2020.
5. The number of shares subject to the option were calculated using a 30-day average price.
6. Options became exercisable in four equal annual installments, commencing 4/1/2021.
7. Option became exercisable in four equal annual installments, commencing 4/1/2022.
8. Option became exercisable in four equal installments, commencing 4/1/2023.
9. Option became exercisable in four equal annual installments, commencing 4/1/2024.
/s/ James D. Clark 12/03/2024
** 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.
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