| 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
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person
*
(Street)
| BENTONVILLE |
AR |
72716-0215 |
|
2. Date of Event Requiring Statement
(Month/Day/Year)
01/01/2017
|
3. Issuer Name
and
Ticker or Trading Symbol
WAL MART STORES INC
[
WMT
]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| Senior Vice President |
|
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
|
15,291.414
|
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 |
| Explanation of Responses: |
|
Jennifer F. Rudolph, by power of attorney |
01/09/2017 |
|
** 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. |
| 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. |
POWER OF ATTORNEY
The undersigned hereby designates Gordon Y. Allison, Geoffrey W. Edwards,
Jennifer F. Rudolph, and Kristopher A. Isham, or any one of them acting singly
and with full power of substitution, as the undersigned?s true and lawful
attorney-in-fact to:
(1) prepare, execute in the undersigned?s name and on the undersigned?s
behalf, and submit to the U.S. Securities and Exchange Commission
(the ?SEC?) a Form ID, including amendments thereto, and any other
documents necessary or appropriate to obtain codes, passwords, and
passphrases enabling the undersigned to make filings with the SEC of
reports required by Section 16(a) of the Securities Exchange Act of
1934, as amended, and Rule 144 of the Securities Act of 1933, as amended,
or any rule or regulation of the SEC;
(2) to execute and file on the undersigned?s behalf all Forms 3, 4, 5,
and 144 (including any amendments thereto) that the undersigned may be
required to file with the SEC and other regulatory bodies as a result of
the undersigned?s ownership of or transactions in securities of Wal-Mart
Stores, Inc., including any filing required as a result of any indirect
ownership of securities attributed to the undersigned under applicable law;
and
(3)do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such Form
3, 4, 5, or 144, complete and execute any amendment or amendments thereto,
and timely file such form with the SEC and any securities exchange or
similar authority.
The authority of Gordon Y. Allison, Geoffrey W. Edwards, Jennifer F.
Rudolph, or Kristopher A. Isham under this Power of Attorney shall continue
until the undersigned is no longer required to file Forms 3, 4, 5, and
144 with regard to the undersigned?s ownership of or transactions in
securities of Wal-Mart Stores, Inc., unless earlier revoked in writing.
The undersigned acknowledges that neither Wal-Mart Stores, Inc., Gordon
Y. Allison, Geoffrey W. Edwards, Jennifer F. Rudolph, nor Kristopher A. Isham
are assuming any of the undersigned?s responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934, as amended, the
Securities Act of 1933, as amended, or any rule or regulation of the SEC.
Date: November 8, 2016 /s/ David Chojnowski
David Chojnowski
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