Statement of Changes in Beneficial Ownership (4)
March 30 2018 - 4:06PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
STORM KORNELIS J.
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2. Issuer Name
and
Ticker or Trading Symbol
BAXTER INTERNATIONAL INC
[
BAX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
ONE BAXTER PARKWAY
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/28/2018
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(Street)
DEERFIELD, IL 60015
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock, $1 par value
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3/28/2018
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M
(1)
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3760
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A
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$33.77
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26272
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D
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Common Stock, $1 par value
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3/28/2018
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M
(2)
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5680
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A
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$26.77
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31952
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D
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Common Stock, $1 par Value
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3/28/2018
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M
(3)
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4320
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A
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$24.27
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36272
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D
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Common Stock, $1 par value
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3/28/2018
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M
(4)
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4990
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A
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$31.26
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41262
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D
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Common Stock, $1 par value
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3/28/2018
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M
(5)
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4020
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A
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$29.51
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45282
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D
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Common Stock, $1 par value
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3/28/2018
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M
(6)
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3930
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A
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$36.92
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49212
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D
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Common Stock, $1 par value
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3/28/2018
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M
(7)
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4110
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A
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$39.83
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53322
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D
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Common Stock, $1 par value
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3/28/2018
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M
(8)
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10789
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A
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$37.50
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64111
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D
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Common Stock, $1 par value
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3/28/2018
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M
(9)
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6360
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A
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$44.39
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70471
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D
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Common Stock, $1 par value
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3/28/2018
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S
(10)
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39059
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D
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$64.55
(11)
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31412
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D
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Common Stock, $1 par value
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3/28/2018
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S
(10)
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8900
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D
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$65.04
(12)
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22512
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Option (Right to Buy)
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$33.77
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3/28/2018
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M
(1)
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3760
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5/6/2009
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5/4/2018
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Common Stock, $1 par value
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3760
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$0
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0
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D
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Stock Option (Right to Buy)
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$26.77
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3/28/2018
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M
(2)
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5680
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5/5/2010
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5/5/2019
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Common Stock, $1 par value
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5680
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$0
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0
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D
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Stock Option (Right to Buy)
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$24.27
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3/28/2018
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M
(3)
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4320
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5/4/2011
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5/4/2020
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Common Stock, $1 par value
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4320
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$0
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0
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D
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Stock Option (Right to Buy)
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$31.26
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3/28/2018
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M
(4)
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4990
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5/8/2012
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5/3/2021
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Common Stock, $1 par value
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4990
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$0
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0
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D
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Stock Option (Right to Buy)
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$29.51
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3/28/2018
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M
(5)
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4020
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5/8/2013
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5/8/2022
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Common Stock, $1 par value
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4020
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$0
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0
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D
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Stock Option (Right to Buy)
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$36.92
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3/28/2018
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M
(6)
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3930
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5/7/2014
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5/5/2023
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Common Stock, $1 par value
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3930
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$0
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0
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D
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Stock Option (Right to Buy)
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$39.83
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3/28/2018
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M
(7)
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4110
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5/5/2015
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5/6/2024
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Common Stock, $1 par value
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4110
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$0
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0
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D
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Stock Option (Right to Buy)
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$37.50
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3/28/2018
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M
(8)
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10789
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5/5/2016
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5/5/2025
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Common Stock, $1 par value
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10789
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$0
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0
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D
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Stock Option (Right to Buy)
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$44.39
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3/28/2018
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M
(9)
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6360
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5/2/2017
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5/1/2026
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Common Stock, $1 par value
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6360
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$0
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0
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D
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Explanation of Responses:
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(1)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by Baxter International Inc. ("BII") to Mr. Storm on May 6, 2008.
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(2)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 5, 2009.
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(3)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 4, 2010.
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(4)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 3, 2011.
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(5)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 8, 2012.
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(6)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 7, 2013.
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(7)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 6, 2014.
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(8)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 5, 2015.
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(9)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm on May 3, 2016.
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(10)
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Transaction effected pursuant to a Rule 10b5-1 trading plan entered into by Mr. Storm with respect to the stock options granted by BII to Mr. Storm.
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(11)
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Price reflects weighted average sales price. Range of prices for transactions are $63.96 through $64.96. Full information regarding the number of shares sold at each separate price will be provided by the issuer upon request.
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(12)
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Price reflects weighted average sales price. Range of prices for transactions are $64.97 through $65.23. Full information regarding the number of shares sold at each separate price will be provided by the issuer upon request.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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STORM KORNELIS J.
ONE BAXTER PARKWAY
DEERFIELD, IL 60015
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X
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Signatures
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/s/ Ellen K. McIntosh, as attorney in-fact for Kornelis J. Storm
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3/30/2018
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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