# EDGAR Filing Document

**Accession Number:** 0000059478
**File Stem:** 0000059478-23-000027
**Filing Date:** 2023-2
**Character Count:** 7369
**Document Hash:** 6de73d81a1556929ef0780440e729b32
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000059478-23-000027.hdr.sgml**: 20230203

**ACCESSION NUMBER**: 0000059478-23-000027

**CONFORMED SUBMISSION TYPE**: 5

**PUBLIC DOCUMENT COUNT**: 2

**CONFORMED PERIOD OF REPORT**: 20221231

**FILED AS OF DATE**: 20230203

**DATE AS OF CHANGE**: 20230203

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Ricks David A
- **CENTRAL INDEX KEY:** 0001538604

**FILING VALUES:**
- **FORM TYPE:** 5
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-06351
- **FILM NUMBER:** 23586551

**MAIL ADDRESS:**
- **STREET 1:** LILLY CORPORATE CENTER
- **CITY:** INDIANAPOLIS
- **STATE:** IN
- **ZIP:** 46285
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** ELI LILLY & Co
- **CENTRAL INDEX KEY:** 0000059478
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **IRS NUMBER:** 350470950
- **STATE OF INCORPORATION:** IN
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** LILLY CORPORATE CTR
- **STREET 2:** DROP CODE 1094
- **CITY:** INDIANAPOLIS
- **STATE:** IN
- **ZIP:** 46285
- **BUSINESS PHONE:** 3172762000

**MAIL ADDRESS:**
- **STREET 1:** LILLY CORPORATE CENTER
- **STREET 2:** DROP CODE 1094
- **CITY:** INDIANAPOLIS
- **STATE:** IN
- **ZIP:** 46285

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** LILLY ELI & CO
- **DATE OF NAME CHANGE:** 19941024

## Ex-24

```
<pre>
David A. Ricks
Lilly Corporate Center
Indianapolis, Indiana  46285

Securities and Exchange Commission
Washington, D.C. 20549

Authorization Regarding Reporting Forms

I hereby authorize and designate the following persons to sign and file with the Commission on my behalf Forms 3, 4, and 5 (including any amendments thereto) covering my transactions and holdings in the common stock and other equity securities of Eli Lilly and Company (the "Company") as required by Section 16 of the Securities Exchange Act of 1934 and the rules thereunder:

Anat Hakim, Lilly Corporate Center, Indianapolis, Indiana

Christopher Anderson, Lilly Corporate Center, Indianapolis, Indiana

Jonathan Groff, Lilly Corporate Center, Indianapolis, Indiana

Valorie Wanner, Lilly Corporate Center, Indianapolis, Indiana

This authorization and designation revoke all prior authorizations and designations relating to reporting under Section 16 of the Securities Exchange Act of 1934 of the Company's securities and shall remain in effect until revoked by a subsequently filed instrument.

February 21, 2022

/s/ David A. Ricks
</pre>
```

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 5

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Ricks David A<br><sub>(Last) (First) (Middle)</sub><br>LILLY CORPORATE CENTER<br><sub>(Street)</sub><br>INDIANAPOLIS, IN 46285<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2022-12-31 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_President, Chair, and CEO_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>ELI LILLY & Co [ LLY ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2022-08-15 |  | G |  | 32467 | D | $0 | 365316 | D |  |
| Common Stock |  |  |  |  |  |  |  | 63500 | I<sup>(1)</sup> | By David A. Ricks SLAT |
| Common Stock |  |  |  |  |  |  |  | 70000 | I<sup>(2)</sup> | By David A. Ricks 2022 GRAT |
| Common Stock |  |  |  |  |  |  |  | 7169 | I | 401(k) |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.

(2) On May 11, 2022, the Reporting Person transferred 70,000 shares of Eli Lilly and Company common stock to a Grantor Retained Annuity Trust, of which the Reporting Person is the trustee.

**Remarks:**
Exhibit 24 - Power of Attorney

**Signature:** /s/ Jonathan Groff for David A. Ricks, pursuant to attached authorization  
**Date:** 2023-02-03

### Remarks:

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.

**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.**