0001179110-21-003313.txt : 20210312 0001179110-21-003313.hdr.sgml : 20210312 20210312133557 ACCESSION NUMBER: 0001179110-21-003313 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210130 FILED AS OF DATE: 20210312 DATE AS OF CHANGE: 20210312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ORBAN GEORGE CENTRAL INDEX KEY: 0001238943 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14678 FILM NUMBER: 21736560 MAIL ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ROSS STORES, INC. CENTRAL INDEX KEY: 0000745732 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-FAMILY CLOTHING STORES [5651] IRS NUMBER: 941390387 STATE OF INCORPORATION: DE FISCAL YEAR END: 0130 BUSINESS ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 BUSINESS PHONE: 9259654400 MAIL ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 FORMER COMPANY: FORMER CONFORMED NAME: ROSS STORES INC DATE OF NAME CHANGE: 19920703 5 1 edgar.xml FORM 5 - X0306 5 2021-01-30 0 0 0 0000745732 ROSS STORES, INC. ROST 0001238943 ORBAN GEORGE 5130 HACIENDA DRIVE DUBLIN CA 94568 1 0 0 0 Common Stock 2020-12-17 5 G 0 92300 0 D 434400 D Common Stock 2020-12-24 5 G 0 19200 0 D 415200 D Common Stock 4373654 I Partnership Common Stock 2020-12-17 5 G 0 30766 0 A 206476 I Trust I Common Stock 2020-12-24 5 G 0 6400 0 A 212876 I Trust I Common Stock 2020-12-30 5 G 0 18441 0 A 231317 I Trust I Common Stock 2020-12-17 5 G 0 30767 0 A 128077 I Trust II Common Stock 2020-12-24 5 G 0 6400 0 A 134477 I Trust II Common Stock 2020-12-30 5 G 0 18441 0 A 152918 I Trust II Common Stock 120400 I Trust III Common Stock 2020-12-17 5 G 0 30767 0 A 128077 I Trust IV Common Stock 2020-12-24 5 G 0 6400 0 A 134477 I Trust IV Common Stock 2020-12-30 5 G 0 18441 0 A 152918 I Trust IV Common Stock 42000 I Trust V Common Stock 120400 I Trust VI Bona Fide Gift /s/ Ken Jew for George Orban 2021-03-10