EX-4.1



 Exhibit 4.1 

UNLESS THIS CERTIFICATE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY (“DTC”), TO THE COMPANY OR ITS
AGENT FOR REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY CERTIFICATE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO
CEDE & CO., OR TO SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL INASMUCH AS THE REGISTERED OWNER HEREOF,
CEDE & CO., HAS AN INTEREST HEREIN. 
 UNLESS AND UNTIL THIS GLOBAL NOTE IS EXCHANGED IN WHOLE OR IN PART FOR A GLOBAL NOTE IN
DEFINITIVE REGISTERED FORM, THIS GLOBAL NOTE MAY NOT BE TRANSFERRED EXCEPT AS A WHOLE BY DTC TO A NOMINEE OF DTC OR BY A NOMINEE OF DTC TO DTC OR ANOTHER NOMINEE OF DTC OR BY DTC OR ANY SUCH NOMINEE TO A SUCCESSOR DEPOSITARY OR A NOMINEE OF SUCH
SUCCESSOR DEPOSITARY. 







 CVS HEALTH CORPORATION 
  

			
	No. [    ]	  	                    $[    ]
		
	CUSIP No. 126650 CT5	  	
	ISIN No. US126650CT50	  	

 2.125% Senior Note due 2021 

CVS HEALTH CORPORATION, a Delaware corporation (such corporation, and its successors and assigns under the Indenture hereinafter referred to,
being herein called the “Company”), for value received promises to pay to CEDE & CO., or registered assigns, the principal sum of $[    ] on June 1, 2021. If such maturity date is not a Business
Day, then payment of principal will be made on the next succeeding Business Day and no interest will accrue on the amount so payable for the period from such maturity date to the date payment is made. 

Interest Payment Dates: June 1 and December 1. 

Record Dates: Each May 17 and November 16, immediately preceding each Interest Payment Date. 

Additional provisions of this Note are set forth on the reverse side of this Note. 

[Remainder of page intentionally left blank] 







 IN WITNESS WHEREOF, the Company has caused this Note to be duly executed. 

 

					
	CVS HEALTH CORPORATION
		
	By:	 	  

		 	Name:	 	Carol A. DeNale
		 	Title:	 	Senior Vice President and Treasurer
		
	By:	 	  

		 	Name:	 	David Denton
		 	Title:	 	Executive Vice President and Chief Financial Officer


 [Signature Page to Note No. [    ] of 2021 Notes] 







 Dated: 

TRUSTEE’S CERTIFICATE OF AUTHENTICATION 
 THE BANK OF NEW
YORK MELLON TRUST COMPANY, N.A., 
 as Trustee, certifies that this is one of the Debt Securities referred to in the Indenture. 

 

			
	By	 	  

		 	Authorized Signatory

 [Signature Page to Note No. [    ] of 2021 Notes] 







 2.125% Senior Note due 2021 

This Note is one of a duly authorized series of Notes of CVS Health Corporation, a Delaware corporation (such corporation, and its successors
and assigns under the Indenture hereinafter referred to, being herein called the “Company”), designated as its 2.125% Senior Notes due 2021 (hereinafter referred to as the “Notes”). 

 

	 	(a)	Interest 

 The Company promises to pay interest on the principal amount of this Note at the rate
per annum shown above. 
 The Company will pay interest on the Notes semi-annually on June 1 and December 1 of each year,
commencing December 1, 2016. Interest on the Notes will accrue from the most recent date to which interest has been paid or provided for, or, if no interest has been paid or provided for, from May 25, 2016. Interest will be computed on the
basis of a 360-day year of twelve 30-day months. The Company shall pay interest on overdue principal at the rate borne by the Notes. If any interest payment date is not a Business Day, then payment of interest will be made on the next
succeeding Business Day and no interest will accrue on the amount so payable for the period from such interest payment date to the date payment is made. 
  

	 	(b)	Method of Payment 

 The Company will pay interest on the Notes (except defaulted interest) to
the Persons who are registered Holders thereof at the close of business on the May 17 and November 16 (whether or not a Business Day) immediately preceding the interest payment date even if the Notes are canceled after the record date and
on or before the interest payment date. Holders must surrender Notes to a Paying Agent to collect principal payments. The Company will pay principal, premium, if any, and interest in money of the United States that at the time of payment is legal
tender for payment of public and private debts by wire transfer of immediately available funds to the accounts specified by the Holders, or, if no such account is specified, the Company may pay principal and interest by check payable in such money.
It may mail an interest check to a Holder’s registered address. 
  

	 	(c)	Paying Agent and Registrar 

 Initially, The Bank of New York Mellon Trust Company, N.A., a
national banking association (the “Trustee”), will act as Paying Agent and Registrar. The Company may appoint and change any Paying Agent, Registrar or co-registrar without notice. The Company or any of its domestically incorporated
Wholly Owned Subsidiaries may act as Paying Agent, Registrar or co-registrar. 
  

	 	(d)	Indenture 

 The Company issued the Notes under an Indenture dated as of August 15, 2006
(the “Indenture”), between the Company and the Trustee. The terms of the Notes include those stated in the Indenture and those made part of the Indenture by reference to the Trust Indenture Act of 1939 (15 U.S.C. ss.ss.
77aaa-77bbbb) as in effect on the date of the Indenture (the 

  
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“TIA”). Terms defined in the Indenture and not defined herein have the meanings ascribed thereto in the Indenture. The Notes are subject to all such terms, and Holders of Notes
are referred to the Indenture and the TIA for a statement of those terms. 
 The Notes are general obligations of the Company initially
limited to $1,750,000,000 aggregate principal amount (subject to Section 2.08 of the Indenture). The Company may at any time issue additional Notes under the Indenture in unlimited amounts having the same terms as and treated as a single class
with the Notes for all purposes under the Indenture and will vote together as one class with respect to the Notes. The Indenture imposes certain limitations on the incurrence of certain additional indebtedness by the Company and certain of its
subsidiaries and the entry into certain sale and leaseback arrangements by the Company and certain of its subsidiaries. The Indenture also restricts the ability of the Company to consolidate or merge with or into, or to transfer all or substantially
all its assets to, another person. 
  

	 	(e)	Optional Redemption 

 Prior to May 1, 2021, the Company, at its option, may at any time
redeem all or any portion of the Notes upon not less than 15 nor more than 60 days’ notice, at a redemption price, plus accrued and unpaid interest to the redemption date, equal to the greater of (i) 100% of the principal amount of the
Notes being redeemed or (ii) the sum of the present values of the remaining scheduled payments of principal and interest on the Notes being redeemed (not including any portion of such payments of interest accrued to the redemption date)
discounted to the redemption date on a semiannual basis (assuming a 360-day year consisting of twelve 30-day months) at the applicable Treasury Yield plus 15 basis points. If any redemption date is not a Business Day, then payment of the
redemption price and accrued and unpaid interest will be made on the next succeeding Business Day, and no interest will accrue on the amounts so payable for the period from such redemption date to the date payment is made. 

“Comparable Treasury Issue” means the United States Treasury security selected by an Independent Investment Banker as having
a maturity comparable to the remaining term of the Notes that would be utilized, at the time of selection and in accordance with customary financial practice, in pricing new issues of corporate debt securities of comparable maturity to such
remaining term. 
 “Comparable Treasury Price” means, with respect to any redemption date, (i) the average of the
applicable Reference Treasury Dealer Quotations for such redemption date, after excluding the highest and lowest such applicable Reference Treasury Dealer Quotations, or (ii) if the Independent Investment Banker obtains fewer than four such
Reference Treasury Dealer Quotations, the average of all such Reference Treasury Dealer Quotations. 
 “Independent Investment
Banker” means Barclays Capital Inc. or, if such firm is unwilling or unable to select the applicable Comparable Treasury Issue, an independent investment banking institution of national standing appointed by the Company. 

“Reference Treasury Dealer” means (i) Barclays Capital Inc. and Merrill Lynch, Pierce, Fenner & Smith
Incorporated and their respective successors; provided, however, that if either of the foregoing shall cease to be a primary United States Government securities dealer in New York City (a “Primary Treasury Dealer”),
the Company shall substitute therefor another Primary Treasury Dealer and (ii) any other Primary Treasury Dealers selected by the Company. 

  
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 “Reference Treasury Dealer Quotations” means, with respect to each Reference
Treasury Dealer and any redemption date, the average, as determined by the Independent Investment Banker, of the bid and asked prices for the Comparable Treasury Issue for the Notes (expressed in each case as a percentage of its principal amount)
quoted in writing to the Independent Investment Banker by such Reference Treasury Dealer at 5:00 p.m., New York City time, on the third business day preceding such redemption date. 

“Treasury Yield” means, with respect to any redemption date, the rate per annum equal to the semiannual equivalent yield to
maturity of the Comparable Treasury Issue, assuming a price for the Comparable Treasury Issue (expressed as a percentage of its principal amount) equal to the applicable Comparable Treasury Price for such redemption date. 

 

	 	(f)	Notice of Redemption 

 Notice of redemption shall be transmitted by the Company (or, at the
Company’s request, by the Trustee on the Company’s behalf) to each Holder of Notes to be redeemed. Notes in denominations larger than $2,000 may be redeemed in part but only in whole multiples of $1,000. If money sufficient to pay the
redemption price of and accrued interest on all Notes (or portions thereof) to be redeemed on the redemption date is deposited with the Paying Agent on or before the redemption date and certain other conditions are satisfied, on and after such date
interest ceases to accrue on such Notes (or such portions thereof) called for redemption. 
  

	 	(g)	Offers to Purchase 

 The Indenture provides, as established pursuant to Section 2.03 of the
Indenture, that upon the occurrence of a Change of Control Triggering Event and subject to further limitations contained therein, the Company shall make an offer to purchase outstanding notes in accordance with the procedures set forth in the
Indenture. 
  

	 	(h)	Denominations; Transfer; Exchange 

 The Notes are in registered form without coupons in
denominations of $2,000 and integral multiples of $1,000 in excess thereof. Holders of Notes may transfer or exchange Notes in accordance with the Indenture. The Registrar may require a Holder of Notes, among other things, to furnish appropriate
endorsements or transfer documents and to pay any taxes and fees required by law or permitted by the Indenture. The Registrar need not register the transfer of or exchange any Notes selected for redemption (except, in the case of a Note to be
redeemed in part, the portion of the Note not to be redeemed) or any Notes for a period of 15 days before a selection of Notes to be redeemed or 15 days before an interest payment date. 

 

	 	(i)	Persons Deemed Owners 

 The registered Holder of this Note may be treated as the sole owner of
such Note for all purposes. 

  
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	 	(j)	Unclaimed Money 

 Subject to applicable abandoned property law, if money for the payment of
principal or interest remains unclaimed for two years, the Trustee or Paying Agent shall pay the money back to the Company at its request unless an abandoned property law designates another Person. After any such payment, Holders entitled to the
money must look only to the Company and not to the Trustee or Paying Agent for payment. 
  

	 	(k)	Discharge and Defeasance 

 Subject to certain conditions, the Company at any time may terminate
some or all of its obligations under the Notes and the Indenture if the Company deposits with the Trustee money or U.S. Government Obligations for the payment of principal and interest on the Notes to redemption or maturity, as the case may be. 

 

	 	(l)	Amendment; Waiver 

 Subject to certain exceptions set forth in the Indenture, (i) the
Indenture or the Notes may be amended with the written consent of the Holders of at least a majority in principal amount outstanding of the Notes; and (ii) any default or compliance with any provision may be waived with the written consent of
the Holders of a majority in principal amount of the Notes then outstanding. Subject to certain exceptions set forth in the Indenture, without the consent of any Holder of a Note, the Company and the Trustee may amend the Indenture or the Notes to
cure any ambiguity, omission, defect or inconsistency that does not materially and adversely affect the rights of any Holder of a Note, or to comply with Article 5 of the Indenture or to comply with requirements of the SEC in connection with
the qualification of the Indenture under the TIA. 
  

	 	(m)	Defaults and Remedies 

 If an Event of Default occurs and is continuing, the Trustee or the
Holders of at least 25% in aggregate principal amount of the Notes may declare all the Notes to be due and payable immediately. Certain events of bankruptcy or insolvency are Events of Default which will result in the Notes being due and payable
immediately upon the occurrence of such Events of Default. 
 Holders of Notes may not enforce the Indenture or the Notes except as provided
in the Indenture. The Trustee may refuse to enforce the Indenture or the Notes unless it receives indemnity or security satisfactory to it. Subject to certain limitations, Holders of a majority in principal amount of the Notes may direct the Trustee
in its exercise of any trust or power. The Trustee may withhold from Holders of Notes notice of any continuing Default (except a Default in payment of principal or interest) if it determines that withholding such notice is in the interest of the
Holders of Notes. 
  

	 	(n)	Trustee Dealings with the Company 

 Subject to certain limitations imposed by the TIA, the
Trustee under the Indenture, in its individual or any other capacity, may become the owner or pledgee of Notes and may otherwise deal with and collect obligations owed to it by the Company or its Affiliates and may otherwise deal with the Company or
its Affiliates with the same rights it would have if it were not Trustee. 

  
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	 	(o)	No Recourse Against Others 

 A director, officer, employee or stockholder, as such, of the
Company or the Trustee shall not have any liability for any obligations of the Company under the Notes or the Indenture or for any claim based on, in respect of or by reason of such obligations. By accepting a Note, each Holder of a Note waives and
releases all such liability. The waiver and release are part of the consideration for the issue of the Notes. 
  

	 	(p)	Authentication 

 This Note shall not be valid until an authorized signatory of the Trustee (or
an authenticating agent) manually signs the certificate of authentication on the face of this Note. 
  

	 	(q)	Abbreviations 

 Customary abbreviations may be used in the name of a Holder of a Note or an
assignee, such as TEN COM (=tenants in common), TEN ENT (=tenants by the entireties), JT TEN (=joint tenants with rights of survivorship and not as tenants in common), CUST (=custodian), and U/G/M/A (=Uniform Gift to Minors Act). 

 

	 	(r)	Governing Law 

 This Note shall be governed by, and construed in accordance with, the laws of
the State of New York but without giving effect to applicable principles of conflicts of law to the extent that the application of the laws of another jurisdiction would be required thereby. 

 

	 	(s)	CUSIP Numbers 

 Pursuant to the recommendation promulgated by the Committee on Uniform Security
Identification Procedures, the Company has caused CUSIP numbers to be printed on the Notes and has directed the Trustee to use such CUSIP numbers in notices of redemption as a convenience to Holders of Notes. No representation is made as to the
accuracy of such numbers either as printed on the Notes or as contained in any notice of redemption and reliance may be placed only on the other identification numbers placed thereon. 

 
  

  
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 The Company will furnish to any Holder of a Note upon written request and without charge to such
Holder of a Note a copy of the Indenture. Requests may be made to: 
 CVS Health Corporation 

670 White Plains Road, Suite 210 

Scarsdale, New York 10583 

Attention: Nancy R. Christal 

Terms defined in the Indenture and not otherwise defined herein are used herein as therein defined. 

  
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 ASSIGNMENT FORM 

To assign this Note, complete the form below: 

I or we assign and transfer this Note to: 

[Print or type assignee’s name, address and zip code] 

[Insert assignee’s soc. sec. or tax I.D. No.] 

and irrevocably appoint              as agent to 

transfer this Note on the books of CVS Health Corporation. 

The agent may substitute another to act for him. 
  

 
  

			
	Date:                                     
                       	  	Your Signature:                                  
                          

  
  

Sign exactly as your name appears on the face of this Note. 

  
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