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*
CARSON BENJAMIN SR

(Last) (First) (Middle)
JOHN HOPKINS HOSPITAL
600 N. WOLFE ST., HARVEY 811

(Street)
BALTIMORE MD 21287-8811

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
COSTCO WHOLESALE CORP /NEW [ COST ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
10/26/2011
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 10/26/2011 M 12,000 A $37.35 31,500 D
Common Stock 10/26/2011 S 12,000 D (1) 19,500 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 $37.35 10/26/2011 M 12,000 04/01/2004 04/01/2014 Common Stock 12,000 $37.35 0 D
Explanation of Responses:
1. Shares sold as follows: 300 @ 82.2800 200 @ 82.3500 100 @ 82.3700 200 @ 82.4300 100 @ 82.4400 200 @ 82.4500 200 @ 82.4600 100 @ 82.5600 100 @ 82.6500 100 @ 82.6700 300 @ 82.7300 100 @ 82.7600 100 @ 82.7703 283 @ 82.7900 76 @ 82.8100 93 @ 82.8200 148 @ 82.8300 100 @ 82.8400 100 @ 82.8500 100 @ 82.8532 200 @ 82.8600 200 @ 82.8700 100 @ 82.9200 200 @ 82.9500 200 @ 82.9600 100 @ 82.9700 100 @ 82.9704 100 @ 82.9710 200 @ 82.9900 100 @ 83.0100 100 @ 83.0200 200 @ 83.0300 100 @ 83.0400 200 @ 83.0800 300 @ 83.1200 100 @ 83.1400 100 @ 83.1600 200 @ 83.3700 200 @ 83.4500 100 @ 83.5600 100 @ 83.5700 100 @ 83.6100 100 @ 83.6200 200 @ 83.6300 100 @ 83.6400 100 @ 83.6500 100 @ 83.6600 100 @ 83.6700 300 @ 83.6800 188 @ 83.6900 2800 @ 83.7000 400 @ 83.7100 300 @ 83.7400 112 @ 83.7500 500 @ 83.8100 50 @ 83.8200 200 @ 83.8400 50 @ 83.8900 100 @ 84.0100
Remarks:
Deanna K. Nakashima, attorney-in-fact 10/27/2011
** 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.
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