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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option 2005/02/25 (right to buy) | $ 31.84 | 02/25/2005 | A | 250,000 | 02/25/2006(5) | 02/24/2015 | Common Stock | 250,000 | $ 0 | 250,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GILMARTIN RAYMOND V ONE MERCK DRIVE P.O. BOX 100 WHITEHOUSE STATION, NJ 08889-0100 |
X | COB, President, CEO |
Debra A. Bollwage as Attorney-in-Fact for Raymond V. Gilmartin | 03/01/2005 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Gilmartin Family Partnership, L.P. (FLP), a limited partnership of which the reporting person and his wife are the sole partners and sole limited partners. Limited partnership interests representing a 15% interest in FLP is held in a trust of which the reporting person's wife is the sole trustee for the benefit of the reporting person's children and grandchildren. Reporting person disclaims beneficial ownership of shares held by FLP to the extent of the trust's interest in FLP. |
(2) | Beneficial ownership as to these shares is disclaimed. |
(3) | Includes shares acquired and dividends earned through January 3, 2005 in the Merck & Co., Inc. Employee Savings and Security Plan, a 401(k) plan. |
(4) | Includes shares held and dividends earned through January 3, 2005 in the Merck Stock Investment Plan. |
(5) | The option vests in three equal annual installments beginning February 25, 2006. |