-----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, CN03+zc0Se1B3pMrOsXzl8ZR63UrZxmnzbY4P/XKzwiU30Kp82iYmazhoPywWY5C foNWcPaMYXWrEMlOYfJV9Q== 0001280367-04-000004.txt : 20040226 0001280367-04-000004.hdr.sgml : 20040226 20040226184843 ACCESSION NUMBER: 0001280367-04-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040226 FILED AS OF DATE: 20040226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GEORGE MICHAEL A CENTRAL INDEX KEY: 0001280367 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14770 FILM NUMBER: 04632116 BUSINESS ADDRESS: STREET 1: 3231 S E SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 BUSINESS PHONE: 785 295 2087 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PAYLESS SHOESOURCE INC /DE/ CENTRAL INDEX KEY: 0001060232 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-SHOE STORES [5661] IRS NUMBER: 431813160 STATE OF INCORPORATION: DE FISCAL YEAR END: 0130 BUSINESS ADDRESS: STREET 1: 3231 SOUTH EAST SIXTH STREET CITY: TOPEKA STATE: KS ZIP: 66607-2207 BUSINESS PHONE: 9132335171 MAIL ADDRESS: STREET 1: 3231 S E 6TH ST CITY: TOPEKA STATE: KS ZIP: 66607-2207 FORMER COMPANY: FORMER CONFORMED NAME: PAYLESS SHOESOURCE HOLDINGS INC DATE OF NAME CHANGE: 19980421 4 1 edgar.xml PRIMARY DOCUMENT X0201 4 2004-02-26 0001060232 PAYLESS SHOESOURCE INC /DE/ PSS 0001280367 GEORGE MICHAEL A 3231 S.E. SIXTH AVENUE TOPEKA KS 66607 1 0 0 0 Phantom Stock 2004-02-26 4 A 0 1000 0 A Common Stock 1000 1000 D Phantom Stock 2004-02-26 4 A 0 693 12.62 A Common Stock 693 1693 D These phantom stock units were acquired under the Company's Deferred Compensation and Restricted Stock Plans for Non-Management Directors and will be settled in shares of stock on a one-for-one basis following termination of services as a Director. 1,000 shares of PSS Common Stock are granted to each Director upon election to the Board. Michael A. George 2004-02-26 -----END PRIVACY-ENHANCED MESSAGE-----