-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, EhFcg3wg8vvymBk1evFBrH+ECfMfv/+6OkMyKu+jsaLgn8N1LmQM6+PE4PzOxeiZ 1nLRhQGfe67iIS3a/iQ7Jw== 0001011438-02-000357.txt : 20020509 0001011438-02-000357.hdr.sgml : 20020509 ACCESSION NUMBER: 0001011438-02-000357 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020430 FILED AS OF DATE: 20020509 COMPANY DATA: COMPANY CONFORMED NAME: PIPKIN HELEN CENTRAL INDEX KEY: 0001168392 OFFICER IRS NUMBER: 954582221 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O 99 CENTS ONLY STORE STREET 2: 4000 UNION PACIFIC AVE CITY: CITY OF COMMERCE STATE: CA ZIP: 90023 BUSINESS PHONE: 3239808145 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: 99 CENTS ONLY STORE CENTRAL INDEX KEY: 0001011290 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-VARIETY STORES [5331] IRS NUMBER: 952411605 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11735 FILM NUMBER: 02639316 BUSINESS ADDRESS: STREET 1: 4000 EAST UNION PACIFIC AVE CITY: CITY OF COMMERCE STATE: CA ZIP: 90023 BUSINESS PHONE: 2139808145 MAIL ADDRESS: STREET 1: 4000 EAST UNION PACIFIC AVENUE CITY: CITY OF COMMERCE STATE: CA ZIP: 90023 4 1 form4-hpipkin.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ________________________________________________________________________________ 1. Name and Address of Reporting Person* PIPKIN HELEN W. - -------------------------------------------------------------------------------- (Last) (First) (Middle) C/O 99 CENTS ONLY STORES 4000 UNION PACIFIC AVENUE - -------------------------------------------------------------------------------- (Street) LOS ANGELES CA 90023 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol 99 CENTS ONLY STORES (NYSE: "NDN") ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year APRIL 2002 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) SENIOR VICE PRESIDENT OF WHOLESALE OPERATIONS ________________________________________________________________________________ 7. 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 Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ----------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ or (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V Amount(1) (D) Price(1) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (ACQUISITION 4/23/02 M 2,800 A $ 2.64 FROM OPTIONS EXERCISED) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (SALE OF STOCK 4/24/02 S 2,800 D 29.49 RECEIVED UPON OPTION OF EXERCISE) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (ACQUISITION 4/23/02 M 9,800 A 11.33 FROM OPTIONS EXERCISED) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (SALE OF STOCK 4/24/02 S 9,800 D 29.49 RECEIVED UPON OPTION OF EXERCISE) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (ACQUISITION 4/23/02 M 10,667 A 17.63 FROM OPTIONS EXERCISED) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (SALE OF STOCK 4/24/02 S 10,667 D 29.49 RECEIVED UPON OPTION OF EXERCISE) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (ACQUISITION 4/23/02 M 10,000 A 17.00 FROM OPTIONS EXERCISED) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK (SALE OF STOCK 4/24/02 S 10,000 D 29.49 0 RECEIVED UPON OPTION OF EXERCISE) ====================================================================================================================================
(Print or Type Response) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship of Form of 2. Deriv- Deriv- Conver- 5. 7. ative ative 11. sion Number of Title and Amount Secur- Secur- Nature or Derivative 6. of Underlying 8. ities ities of Exer- 4. Securities Date Securities Price Bene- Benefi- In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially cially direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned Owned Bene- 1. of action Code of (D) (Month/Day/Year) Amount ative at End at End ficial Title of Deriv- Date (Instr. (Instr. 3, ------------------ or Secur- of of Owner- Derivative ative (Month/ 8) 4 and 5)(1) Date Expira- Number ity Month Month ship Security Secur- Day/ ------ ------------ Exer- tion of Shares (Instr. (Instr. (Instr. (Instr (Instr. 3) ity (1) Year) Code V (A) (D) cisable Date Title (1) 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK $27.35 5/6/01 A 16,000 (3) 5/6/11 COMMON 16,000 OPTION GRANT STOCK (2) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 2.64 4/23/02 M 2,800 (4) 5/1/06 COMMON 2,800 OPTION STOCK EXERCISED - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 11.33 4/23/02 M 9,800 (5) 5/12/08 COMMON 9,800 OPTION STOCK EXERCISED - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 17.63 4/23/02 M 10,667 (6) 5/9/09 COMMON 10,667 OPTION STOCK EXERCISED - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 17.00 4/23/02 M 10,000 (7) 5/4/10 COMMON 10,000 OPTION STOCK EXERCISED - ------------------------------------------------------------------------------------------------------------------------------------ 75,790 D ====================================================================================================================================
Explanation of Responses: (1) All share numbers and prices are adjusted to reflect the Registrant's four-for-three stock dividend issued on April 3, 2002. (2) This line item is reported to correct information previously filed in a Form 4 filed September 10, 2001. The previous report stated that 13,500 shares were underlying the common stock option acquired. The actual number of shares underlying the common stock option acquired was 12,000. As adjusted to reflect the stock split described in footnote 1, the total number of shares of common stock underlying the options granted in this line item is 16,000. (3) Options vest in three equal annual installments beginning May 6, 2002. (4) Options granted on May 1, 1996, vested in three equal annual installments beginning on May 1, 1997. (5) Options granted on May 12, 1998, vested in three equal annual installments beginning on May 12, 1999. (6) Options granted on May 9, 1999, vested in three equal annual installments beginning on May 9, 2000. (7) Options granted on May 4, 2000, vested in three equal annual installments beginning on May 4, 2001. /S/ HELEN W. PIPKIN MAY 9, 2002 - --------------------------------------------- ----------------------- **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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----