-----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, If9eezOXTWyEHVrXnRTEcW+2sl1UkQz2TeZ1Xt2Gk8/RY1ej7JfN+vzHOzB4L2zh C7Kahml2VGofU5mrTXplVA== 0000898080-04-000091.txt : 20040210 0000898080-04-000091.hdr.sgml : 20040210 20040210165928 ACCESSION NUMBER: 0000898080-04-000091 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040210 GROUP MEMBERS: CPS GROUP MEMBERS: DANO GROUP MEMBERS: DDI GROUP MEMBERS: DFS TRUST - 2004 GROUP MEMBERS: SAO GROUP MEMBERS: TWD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: WINN DIXIE STORES INC CENTRAL INDEX KEY: 0000107681 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 590514290 STATE OF INCORPORATION: FL FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-32516 FILM NUMBER: 04582692 BUSINESS ADDRESS: STREET 1: 5050 EDGEWOOD CT CITY: JACKSONVILLE STATE: FL ZIP: 32224 BUSINESS PHONE: 9047835000 MAIL ADDRESS: STREET 1: 5050 EDWOOD CT CITY: JACKSONVILLE STATE: FL ZIP: 32254 FORMER COMPANY: FORMER CONFORMED NAME: WINN & LOVETT GROCERY INC DATE OF NAME CHANGE: 19710927 FORMER COMPANY: FORMER CONFORMED NAME: WINN & LOVETT GROCERY CO DATE OF NAME CHANGE: 19671119 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: D D I INC ET AL CENTRAL INDEX KEY: 0000901575 IRS NUMBER: 592448386 STATE OF INCORPORATION: FL FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: PO BOX 19366 CITY: JACKSONVILLE STATE: FL ZIP: 32245-9366 BUSINESS PHONE: 9042237495 MAIL ADDRESS: STREET 1: PO BOX 19366 CITY: JACKSONVILLE STATE: FL ZIP: 32245-9366 FORMER COMPANY: FORMER CONFORMED NAME: DAVIS A DARIUS/JED/DDI/TWD/ADD/RDD/CPS DATE OF NAME CHANGE: 19930421 SC 13G 1 formsc13g.txt SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 16) Winn-Dixie Stores, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 974280 10 9 ----------------------------------------------------------- (CUSIP Number) December 31, 2003 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: / / Rule 13d-1(b) / / Rule 13d-1(c) /X/ Rule 13d-1(d) * The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). (Continued on following page(s)) Page 1 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------
======================================================================================================= 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) D.D.I., Inc. - ------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) /X/ (b) / / - ------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Florida - United States - ------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 40,787,332 ---------------------------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY -0- ---------------------------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 40,787,332 ---------------------------------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH -0- - ------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 40,787,332 - ------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) / / None Excluded - ------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 28.8% - ------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) CO =======================================================================================================
Page 2 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ Item 1(a). Name of Issuer: Winn-Dixie Stores, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 5050 Edgewood Ct., Jacksonville, FL 32254-3699 Item 2(a). Name of Person Filing: D.D.I., Inc. Item 2(b). Address of Principal Business Office or, if none, Residence: 4310 Pablo Oaks Court, Jacksonville, FL 32224 Item 2(c). Citizenship: Florida - United States Item 2(d). Title of Class of Securities: Common Stock Item 2(e). CUSIP Number: 974280 10 9 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: N/A Item 4. Ownership The following ownership information is provided as of December 31, 2003. The reporting person has the right to acquire additional shares as such right is defined in Rule 13d-3. Such shares are included in this Item 4 and are disclosed in Note (A) to Exhibit I hereto. (a) Amount Beneficially Owned: 40,787,332 (b) Percent of Class: 28.8% Page 3 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 40,787,332 (ii) shared power to vote or to direct the vote: -0- (iii) sole power to dispose or to direct the disposition of: 40,787,332 (iv) shared power to dispose or to direct the disposition of: -0- Item 5. Ownership of Five Percent or Less of a Class. N/A Item 6. Ownership of More than Five Percent on Behalf of Another Person. N/A Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. N/A Item 8. Identification and Classification of Members of the Group. See Exhibit I for the identity of the group members filing this schedule. Item 9. Notice of Dissolution of Group. N/A Item 10. Certification. N/A Page 4 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. __February 10, 2004_______________ Date By:___/s/ H. J. Skelton______________ [Signature] D.D.I., Inc. H. J. Skelton, President_____________ [Name/Title] Page 5 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------
======================================================================================================= 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Davis Family Special Trust 2004 - ------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) /X/ (b) / / - ------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Florida - United States - ------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 52,653,666 -------------------------------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY -0- -------------------------------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 52,653,666 -------------------------------------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH -0- - ------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 52,653,666 - ------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) / / None Excluded - ------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 37.1% - ------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) OO =======================================================================================================
Page 6 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ Item 1(a). Name of Issuer: Winn-Dixie Stores, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 5050 Edgewood Ct., Jacksonville, FL 32254-3699 Item 2(a). Name of Person Filing: Davis Family Special Trust 2004 Item 2(b). Address of Principal Business Office or, if none, Residence: 4310 Pablo Oaks Court, Jacksonville, FL 32224 Item 2(c). Citizenship: Florida - United States Item 2(d). Title of Class of Securities: Common Stock Item 2(e). CUSIP Number: 974280 10 9 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: N/A Item 4. Ownership The following ownership information is provided as of December 31, 2003. The reporting person does not have any current right to acquire additional shares as such right is defined in Rule 13d-3. (a) Amount Beneficially Owned: 52,653,666 (b) Percent of Class: 37.1% Page 7 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 52,653,666 (ii) shared power to vote or to direct the vote: -0- (iii) sole power to dispose or to direct the disposition of: 52,653,666 (iv) shared power to dispose or to direct the disposition of: -0- Item 5. Ownership of Five Percent or Less of a Class. N/A Item 6. Ownership of More than Five Percent on Behalf of Another Person. N/A Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. N/A Item 8. Identification and Classification of Members of the Group. See Exhibit I for the identity of the group members filing this schedule. Item 9. Notice of Dissolution of Group. N/A Item 10. Certification. N/A Page 8 of 28 Pages - --------------------------- CUSIP No. 974280 10 9 - --------------------------- SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. __February 10, 2004________________ Date By:___/s/ Scott A. Oko ____________ [Signature] Davis Family Special Trust 2004 Scott A. Oko, Trustee ______________ [Name/Title] Page 9 of 28 Pages - --------------------------- CUSIP No. 974280 10 9 - ---------------------------
======================================================================================================= 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Scott A. Oko - ------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) /X/ (b) / / - ------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Florida - United States - ------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 52,653,666 -------------------------------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY -0- -------------------------------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 52,653,666 -------------------------------------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH -0- - ------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 52,653,666 - ------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) / / None Excluded - ------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 37.1% - ------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) IN =======================================================================================================
Page 10 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ Item 1(a). Name of Issuer: Winn-Dixie Stores, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 5050 Edgewood Ct., Jacksonville, FL 32254-3699 Item 2(a). Name of Person Filing: Scott A. Oko Item 2(b). Address of Principal Business Office or, if none, Residence: 4310 Pablo Oaks Court, Jacksonville, FL 32224 Item 2(c). Citizenship: Florida - United States Item 2(d). Title of Class of Securities: Common Stock Item 2(e). CUSIP Number: 974280 10 9 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: N/A Item 4. Ownership The following ownership information is provided as of December 31, 2003. The reporting person does not have any current right to acquire additional shares as such right is defined in Rule 13d-3. (a) Amount Beneficially Owned: 52,653,666 (b) Percent of Class: 37.1% Page 11 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 52,653,666 (ii) shared power to vote or to direct the vote: -0- (iii) sole power to dispose or to direct the disposition of: 52,653,666 (iv) shared power to dispose or to direct the disposition of: -0- Item 5. Ownership of Five Percent or Less of a Class. N/A Item 6. Ownership of More than Five Percent on Behalf of Another Person. N/A Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. N/A Item 8. Identification and Classification of Members of the Group. See Exhibit I for the identity of the group members filing this schedule. Item 9. Notice of Dissolution of Group. N/A Item 10. Certification. N/A Page 12 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. __February 10, 2004________________ Date ___/s/ Scott A. Oko_________________ [Signature] Scott A. Oko_______________________ [Name/Title] Page 13 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------
======================================================================================================= 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) T. Wayne Davis - ------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) /X/ (b) / / - ------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Florida - United States - ------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 239,273 -------------------------------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 40,814,316 -------------------------------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 239,273 -------------------------------------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH 40,814,316 - ------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 41,053,589 - ------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) / / None Excluded - ------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 29.0% - ------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) IN =======================================================================================================
Page 14 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ Item 1(a). Name of Issuer: Winn-Dixie Stores, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 5050 Edgewood Ct., Jacksonville, FL 32254-3699 Item 2(a). Name of Person Filing: T. Wayne Davis Item 2(b). Address of Principal Business Office or, if none, Residence: 1910 San Marco Blvd., Jacksonville, FL 32207 Item 2(c). Citizenship: Florida - United States Item 2(d). Title of Class of Securities: Common Stock Item 2(e). CUSIP Number: 974280 10 9 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: N/A Item 4. Ownership The following ownership information is provided as of December 31, 2003. The reporting person has the right to acquire additional shares as such right is defined in Rule 13d-3. Such shares are included in this Item 4 and are disclosed in Note (A) to Exhibit I hereto. (a) Amount Beneficially Owned: 41,053,589 (b) Percent of Class: 29.0% Page 15 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 239,273 (ii) shared power to vote or to direct the vote: 40,814,316 (iii) sole power to dispose or to direct the disposition of: 239,273 (iv) shared power to dispose or to direct the disposition of: 40,814,316 Item 5. Ownership of Five Percent or Less of a Class. N/A Item 6. Ownership of More than Five Percent on Behalf of Another Person. N/A Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. N/A Item 8. Identification and Classification of Members of the Group. See Exhibit I for the identity of the group members filing this schedule. Item 9. Notice of Dissolution of Group. N/A Item 10. Certification. N/A Page 16 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. __February 10, 2004________________ Date By:____/s/ H. J. Skelton_____________ [Signature] T. Wayne Davis, Director By: H. J. Skelton, Attorney-in-Fact___ [Name/Title] Page 17 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------
======================================================================================================= 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) A. Dano Davis - ------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) /X/ (b) / / - ------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Florida - United States - ------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 4,980,930 -------------------------------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 42,811,218 -------------------------------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 4,980,930 -------------------------------------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH 42,811,218 - ------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 47,792,148 - ------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) / / None Excluded - ------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 33.7% - ------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) IN =======================================================================================================
Page 18 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ Item 1(a). Name of Issuer: Winn-Dixie Stores, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 5050 Edgewood Ct., Jacksonville, FL 32254-3699 Item 2(a). Name of Person Filing: A. Dano Davis Item 2(b). Address of Principal Business Office or, if none, Residence: 4310 Pablo Oaks Court, Jacksonville, FL 32224 Item 2(c). Citizenship: Florida - United States Item 2(d). Title of Class of Securities: Common Stock Item 2(e). CUSIP Number: 974280 10 9 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: N/A Item 4. Ownership The following ownership information is provided as of December 31, 2003. The reporting person has the right to acquire additional shares as such right is defined in Rule 13d-3. Such shares are included in this Item 4 and are disclosed in Note (A) to Exhibit I hereto. (a) Amount Beneficially Owned: 47,792,148 (b) Percent of Class: 33.7% Page 19 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 4,980,930 (ii) shared power to vote or to direct the vote: 42,811,218 (iii) sole power to dispose or to direct the disposition of: 4,980,930 (iv) shared power to dispose or to direct the disposition of: 42,811,218 Item 5. Ownership of Five Percent or Less of a Class. N/A Item 6. Ownership of More than Five Percent on Behalf of Another Person. N/A Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. N/A Item 8. Identification and Classification of Members of the Group. See Exhibit I for the identity of the group members filing this schedule. Item 9. Notice of Dissolution of Group. N/A Item 10. Certification. N/A Page 20 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. __February 10, 2004________________ Date By:____/s/ H. J. Skelton_____________ [Signature] A. Dano Davis, Director By: H. J. Skelton, Attorney-in-Fact___ [Name/Title] Page 21 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------
======================================================================================================= 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Charles P. Stephens - ------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) /X/ (b) / / - ------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Georgia - United States - ------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 215,948 -------------------------------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 41,580,841 -------------------------------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 215,948 -------------------------------------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH 41,580,841 - ------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 41,796,789 - ------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) / / None Excluded - ------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 29.5% - ------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) IN =======================================================================================================
Page 22 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ Item 1(a). Name of Issuer: Winn-Dixie Stores, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 5050 Edgewood Ct., Jacksonville, FL 32254-3699 Item 2(a). Name of Person Filing: Charles P. Stephens Item 2(b). Address of Principal Business Office or, if none, Residence: P O Box 2100, Peachtree City, GA 30269 Item 2(c). Citizenship: Georgia - United States Item 2(d). Title of Class of Securities: Common Stock Item 2(e). CUSIP Number: 974280 10 9 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: N/A Item 4. Ownership The following ownership information is provided as of December 31, 2003. The reporting person has the right to acquire additional shares as such right is defined in Rule 13d-3. Such shares are included in this Item 4 and are disclosed in Note (A) to Exhibit I hereto. (a) Amount Beneficially Owned: 41,796,789 (b) Percent of Class: 29.5% Page 23 of 28 Pages - --------------------------- CUSIP No. 974280 10 9 - --------------------------- (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 215,948 (ii) shared power to vote or to direct the vote: 41,580,841 (iii) sole power to dispose or to direct the disposition of: 215,948 (iv) shared power to dispose or to direct the disposition of: 41,580,841 Item 5. Ownership of Five Percent or Less of a Class. N/A Item 6. Ownership of More than Five Percent on Behalf of Another Person. N/A Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. N/A Item 8. Identification and Classification of Members of the Group. See Exhibit I for the identity of the group members filing this schedule. Item 9. Notice of Dissolution of Group. N/A Item 10. Certification. N/A Page 24 of 28 Pages - ------------------------------ CUSIP No. 974280 10 9 - ------------------------------ SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. __February 10, 2004________________ Date By:____/s/ H. J. Skelton_____________ [Signature] Charles P. Stephens, Director By: H. J. Skelton, Attorney-in-Fact___ [Name/Title] Page 25 of 28 Pages Exhibit I
OWNERS OF 5% OR MORE OF OUTSTANDING SHARES DECEMBER 31, 2003 SOLE VOTING AND DISPOSITIVE POWER ----------------------------------------------------------------------- T. SHARED VOTING WAYNE A. DANO CHARLES P. DFS TRUST 2004 Other Family AND Total No. of DAVIS DAVIS STEPHENS SAO (***) Members Owning DISPOSITIVE OWNER (**) Shares ("TWD") ("DANO") ("CPS") ("DFS") (A) Less than 5% POWER ---------- ------ ------- -------- ------- ----------- ------------ ----- DFS TRUST 2004 52,653,666 (A) - - - 52,653,666 - - ADFAM PARTNERS, LTD. 7,850 (B) - - - - - 7,850 AKD-SDS PARTNERS I, LTD. 248,557 (C) - - - - 248,557 - AKD-KDO PARTNERS I, LTD. 248,556 (C) - - - - 248,556 - AKD-CDC PARTNERS I, LTD. 248,557 (C) - - - - 248,557 - VD - WD CHARITIES, INC. 2,984 (D) - - - - - 2,984 KIT'S SUNRISE INVEST., L.L.C. 98,806 (E) - - - - - 98,806 FLODOT, L.L.C. 30,000 (E) - - - - - 30,000 JED - WD CHARITIES, INC. 12,572 (F) - - - - - 12,572 JED FAMILY TRUSTS 275,588 (G) - 3,000 - - 138,110 134,478 DANO FAMILY AND TRUST 215,604 (H) - 100,124 - - - 115,480 ADFAM CHARITIES, INC. 600 (I) - - - - - 600 ADD FAMILY AND TRUSTS 864,090 (J) - - - - 864,090 - MAD FAMILY TRUSTS 48,453 (K) - - - - - 48,453 CPS FAMILY 991,009 (L) - - 172,509 - 27,975 790,525 TWD - WD CHARITIES, INC. 24,000 (M) - - - - - 24,000 TWD - RETIREMENT PLANS 1,400 1,400 - - - - - OTHER FAM AND TRS OF TWD 27,707 (N) - - - - 27,707 - TWD FAMILY 107,970 (O) 107,970 - - - - - 56,107,969 109,370 103,124 172,509 52,653,666 1,803,552 1,265,748 ========== ======= ======= ======= ========== ========= ========= Percent of Class 39.6% 0.1% 0.1% 0.1% 37.1% 1.3% 0.9%
(**) References to ADD and JED pertain to A. Darius Davis and James E. Davis, respectively. ADD, JED, Tine W. Davis ("Tine") and M. Austin Davis ("MAD"), all of which were brothers and the founders of the issuer, are deceased. DANO, TWD and CPS are the son of JED, son of Tine, and son-in-law of MAD, respectively. (***) References to SAO pertain to Scott A. Oko, trustee of DFS Trust 2004. Page 26 of 28 Pages (A) A trust, formed on December 12, 2003, to which certain shareholders of the issuer, DDI, Inc. and Estuary Corporation ("Estuary") (collectively, the "Grantors") contributed their shares of such corporations' stock in exchange for separate shares of beneficial interest in the trust. As a result of such contributions of securities by the Grantors, the trust has beneficial interest in 37.1% of the issuer's common stock. Such shares of beneficial interest in the trust were held directly on December 31, 2003. On January 2, 2004, the trust was terminated and the following shares of the issuer's common stock were distributed to Grantors for which the following reporting persons have sole or shared voting and dispositive powers. Voting and Dispositive Powers -------------------------------------- Reporting Person Sole Shared ------------ -------------------------------------- TWD 129,903 DANO 4,877,806 1,758,372 CPS 43,439 DDI 40,787,332 (*) ------------- ------------ 45,838,480 1,758,372 ============= ============ (*) Also shared by TWD, DANO and CPS. (B) Limited partnership of which all its limited partners are either an ADD family member, trusts FBO ADD family members, or a limited liability company of which its members are individual ADD family members or trusts FBO ADD family members. A corporation, owned 50% by an ADD family member and 50% by a trust FBO an ADD family member, is the general partner. (C) Limited partnership of which its limited partners are trusts FBO MAD family members and the general partner is a corporation, controlled by a non-family member, which is wholly owned by a trust FBO a MAD family member. (D) Private charitable foundation of which TWD, DANO and CPS are directors. (E) Limited Liability Corporation controlled by DANO's sister and her five children. (F) Private charitable foundation of which DANO, his sister and his mother are directors and DANO is an officer. (G) Trusts of which DANO and/or his sister are co-trustees or sole trustee, and his mother and his sister's children are the beneficiaries. (H) DANO, individually, and trusts FBO DANO or his sons of which DANO is sole trustee or co-trustee. (I) Private charitable foundation of which ADD family members are directors. (J) ADD family members, individually, and trusts FBO ADD family members. Page 27 of 28 (K) Trusts FBO MAD family members. (L) CPS, his wife, and his son, each individually, and irrevocable trusts of which CPS is co-trustee with his wife and his wife and children are beneficiaries. (M) Private charitable foundation of which TWD is a director. (N) A trust FBO TWD's nephew, TWD's sister as custodian for her grandchild and trusts FBO TWD's sister's grandchildren. (O) TWD, individually and as custodian for his grandchildren, a revocable trust of which TWD is sole trustee and beneficiary and irrevocable trusts FBO TWD's daughters of which TWD is sole trustee. Page 28 of 28 Pages -----END PRIVACY-ENHANCED MESSAGE-----