-----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, SUWcRONYzeozwHH71nxKr4Mqo+D1cyLuNmRH+he+6+pJGgp6ZdY4qPdmiyz5n6b3 ZUWSvP3VaW8G93Jc6tMXDw== 0000878314-03-000013.txt : 20031031 0000878314-03-000013.hdr.sgml : 20031031 20031031130740 ACCESSION NUMBER: 0000878314-03-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031030 FILED AS OF DATE: 20031031 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DUNCAN SAM K CENTRAL INDEX KEY: 0001217660 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 03969083 MAIL ADDRESS: STREET 1: 700 PILGRIM WAY CITY: GREENBAY STATE: WI ZIP: 54304 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SHOPKO STORES INC CENTRAL INDEX KEY: 0000878314 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-VARIETY STORES [5331] IRS NUMBER: 410985054 STATE OF INCORPORATION: WI FISCAL YEAR END: 0222 BUSINESS ADDRESS: STREET 1: 700 PILGRIM WAY CITY: GREEN BAY STATE: WI ZIP: 54304 BUSINESS PHONE: 9204972211 MAIL ADDRESS: STREET 1: PO BOX 19060 CITY: GREEN BAY STATE: WI ZIP: 54307-9060 4 1 primary_doc.xml PRIMARY DOCUMENT X0201 4 2003-10-30 0 0000878314 SHOPKO STORES INC SKO 0001217660 DUNCAN SAM K 700 PILGRIM WAY GREENBAY WI 54304 1 1 0 0 President, CEO Common Stock 2003-10-30 4 F 0 4150 15.62 D 45850 D Shares are being surrendered to satisfy withholding tax obligations w/ respect to 12,500 shares on which restrictions are lapsing. Includes 37,500 restricted shares. Peter Vandenhouten, Power of Attorney 2003-10-31 -----END PRIVACY-ENHANCED MESSAGE-----