SEC FORM 3 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*
Fry Stephen F

(Last) (First) (Middle)
LILLY CORPORATE CENTER

(Street)
INDIANAPOLIS IN 46285

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/11/2011
3. Issuer Name and Ticker or Trading Symbol
LILLY ELI & CO [ LLY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, HR & Diversity
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)
Common Stock 13,071 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
Restricted Stock Unit 12/03/2017 12/03/2017 Common Stock 7,557 (1) D
Restricted Stock Unit 12/03/2012 12/03/2012 Common Stock 3,778 (1) D
Employee stock option 2/06 (right to buy) 02/10/2009 02/09/2016 Common Stock 7,530 56.18 D
Employee stock option 2/05 (right to buy) 02/11/2008 02/10/2015 Common Stock 9,231 55.65 D
Employee stock option 2/04 (right to buy) 02/19/2007 02/14/2014 Common Stock 14,000 73.11 D
Employee stock option 2/03 (right to buy) 02/16/2006 02/15/2013 Common Stock 12,500 57.85 D
Employee stock option 2/02 (right to buy) 02/18/2005 02/17/2012 Common Stock 11,050 75.92 D
Employee stock option 10/01 (right to buy) 10/03/2003 10/04/2011 Common Stock 5,000 79.28 D
Explanation of Responses:
1. Each restricted stock unit represents a contingent right to receive one share of Eli Lilly and Company common stock.
Remarks:
Stephen F. Fry 02/22/2011
** 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 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.
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