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*
Bachmann Lisa M

(Last) (First) (Middle)
300 PHILLIPI ROAD

(Street)
COLUMBUS OH 43228

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/29/2005
3. Issuer Name and Ticker or Trading Symbol
BIG LOTS INC [ BLI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP of IT/Merchandise Planning
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 16,000 D
Common Stock 938 I By 401(K) Plan(1)
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
Stock Purchase Option (2) 03/25/2012 Common Stock 50,000 $14.2 D
Stock Purchase Option (3) 02/24/2013 Common Stock 30,000 $10.85 D
Stock Purchase Option (4) 02/23/2014 Common Stock 50,000 $15.05 D
Phantom Stock (5) (6) Common Stock 302(7) (8) D
Explanation of Responses:
1. Common stock held under the Big Lots Savings Plan ("401(K) Plan") as a result of matching contributions made by the Issuer in the form of the Issuer's common stock, as contemplated by the terms of the 401(K) Plan. This information is based on a 401(K) Plan report dated as of August 26, 2005.
2. The option began vesting in five equal annual installments on March 25, 2003.
3. The option began vesting in five equal annual installments on February 24, 2004.
4. The option began vesting in five equal annual installments on February 23, 2005.
5. Immediately.
6. Not applicable.
7. Phantom stock held under the Big Lots, Inc. Supplemental Savings Plan ("Supplemental Plan") as a result of matching contributions made by the Issuer in the form of the Issuer's common stock, as contemplated by the terms of the Supplemental Plan. This information is based on a Supplemental Plan report dated as of August 26, 2005.
8. One-for-one.
Remarks:
Charles W. Haubiel II, attorney in fact for Lisa M. Bachmann 08/31/2005
** 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.