0001179110-12-016583.txt : 20121128
0001179110-12-016583.hdr.sgml : 20121128
20121128172807
ACCESSION NUMBER: 0001179110-12-016583
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121126
FILED AS OF DATE: 20121128
DATE AS OF CHANGE: 20121128
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FASTENAL CO
CENTRAL INDEX KEY: 0000815556
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-BUILDING MATERIALS, HARDWARE, GARDEN SUPPLY [5200]
IRS NUMBER: 410948415
STATE OF INCORPORATION: MN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2001 THEURER BLVD
CITY: WINONA
STATE: MN
ZIP: 55987
BUSINESS PHONE: 5074545374
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Polipnick Gary A.
CENTRAL INDEX KEY: 0001555049
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-16125
FILM NUMBER: 121229850
MAIL ADDRESS:
STREET 1: 2413 ADVANCE ROAD
CITY: MADISON
STATE: WI
ZIP: 53718
4
1
edgar.xml
FORM 4 -
X0306
4
2012-11-26
0
0000815556
FASTENAL CO
FAST
0001555049
Polipnick Gary A.
2413 ADVANCE ROAD
MADISON
WI
53718
0
1
0
0
Executive Vice President
Common Stock
2012-11-26
4
P
0
1000
40.50
A
3672
I
By Trust
Common Stock
54307
D
Common Stock
1735
D
Common Stock
898
I
Held by Spouse
Common Stock
2478
I
Held by Daughter
Common Stock
1796
I
Held in custodian account for Daughter
Common Stock
896
I
Held in custodian account for Daughter
Common Stock
3046
I
Held in 401(K) Plan
Reporting person's spouse serves as a Trustee of a Trust for the benefit of spouse's sibling.
Shares maintained in a self-directed IRA.
Reporting person disclaims beneficial ownership of these shares.
Shares attributed to reporting person's account within issuer's 401(K) Plan as of September 30, 2012.
/s/ John J. Milek, Attorney-in-Fact
2012-11-28