SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
SCHOLZ MIA M

(Last) (First) (Middle)
200 WILMOT ROAD

(Street)
DEERFIELD IL 60015

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/14/2004
3. Issuer Name and Ticker or Trading Symbol
WALGREEN CO [ WAG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Controller
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Walgreen Co. Common Stock 2,997 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) 11/01/2002 11/01/2009 Common Stock 2,283 $25.1875 D
Employee Stock Option (Right to Buy) 05/11/2003 05/11/2010 Common Stock 75 $29.1875 D
Employee Stock Option (Right to Buy) 09/01/2003 09/01/2010 Common Stock 2,099 $32.875 D
Employee Stock Option (Right to Buy) 10/31/2002 10/31/2010 Common Stock 504 $38.7812(1) D
Employee Stock Option (Right to Buy) 09/01/2004 09/01/2011 Common Stock 3,516 $34.35 D
Employee Stock Option (Right to Buy) 09/01/2005 09/01/2012 Common Stock 5,352 $34.75 D
Employee Stock Option (Right to Buy) 03/11/2006 03/11/2013 Common Stock 100 $27.75 D
Employee Stock Option (Right to Buy) 09/01/2006 09/01/2013 Common Stock 5,996 $32.57 D
Employee Stock Option (Right to Buy) 12/31/2006 12/31/2013 Common Stock 1,108 $36.38 D
Explanation of Responses:
1. The full exercise price is $38.78125 per share.
Remarks:
Mia M. Scholz 01/15/2004
** 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 5 (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.