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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 12/02/2008 |
3. Issuer Name and Ticker or Trading Symbol
COLLECTIVE BRANDS, INC. [ PSS ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 2,287 | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Employee Stock Option | (1) | 05/31/2012 | Common Stock | 7,000 | $16.865 | D | |
Employee Stock Option | 05/31/2009(2) | 04/07/2013 | Common Stock | 5,000 | $22.48 | D | |
Employee Stock Option | (3) | 04/07/2013 | Common Stock | 2,100 | $22.48 | D | |
Stock Appreciation Right | (4) | 04/07/2013 | Common Stock | 1,925 | $22.48 | D | |
Stock Appreciation Right | (4) | 04/07/2013 | Common Stock | 5,500 | $22.48 | D | |
Stock Appreciation Right | 05/31/2010(6) | 03/29/2014 | Common Stock | 4,000 | $33.115 | D | |
Stock Appreciation Right | (5) | 03/29/2014 | Common Stock | 3,925 | $33.115 | D | |
Stock Appreciation Right | (7) | 09/04/2014 | Common Stock | 5,080 | $23.16 | D | |
Stock Appreciation Right | 03/27/2011(6) | 03/27/2015 | Common Stock | 5,000 | $12.45 | D | |
Stock Appreciation Right | 09/08/2011(6) | 09/08/2015 | Common Stock | 2,000 | $18.63 | D |
Explanation of Responses: |
1. Grant of an option to buy 10,500 shares of common stock under the Payless ShoeSource, Inc. 1996 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b3. The option vests in three equal installments over a three-year period beginning on the first anniversary of the date of grant. |
2. Grant of an option to buy 5,000 shares of common stock under the Payless ShoeSource, Inc. 1996 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b3. The option has a three-year cliff vest. |
3. Grant of an option to buy 2,100 shares of common stock under the Payless ShoeSource, Inc. 1996 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b3. The option vests in three equal installments over a three-year period beginning on the first anniversary of the date of grant. |
4. The stock appreciation right granted under the Payless ShoeSource, Inc. 1996 Stock Incentive Plan which provides for tax withholding rights under Rule 16b-3. The option vests in three equal installments over a three-year period on May 31 of each year following the date of the grant. The stock appreciation right is required to be settled in stock. |
5. The stock appreciation right granted under the Payless ShoeSource, Inc. 2006 Stock Incentive Plan which provides for tax withholding rights under Rule 16b-3. The option vests in three equal installments over a three-year period on May 31 of each year following the date of the grant. The stock appreciation right is required to be settled in stock. |
6. The stock appreciation right granted under the Payless ShoeSource, Inc. 2006 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b-3. The option has a three-year cliff vest. The stock appreciation right is required to be settled in stock. |
7. The stock appreciation right granted under the Payless hoeSource, Inc. 2006 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b-3. The option vests in three equal installments over a three-year period on September 4th of each year following the date of the grant. The stock appreciation right is required to be settled in stock. |
Remarks: |
Douglas G. Boessen | 12/02/2008 | |
** 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. | ||
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. |