-----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, HK01g3hTYMyNvZ9wi7a5lQ3c3wTtrlO9prgz1+wzAKgBU+sSjOUx83KUgLPNC92C nKvjAHc1vjYwX8DtSxOBhA== 0000878314-04-000006.txt : 20040527 0000878314-04-000006.hdr.sgml : 20040527 20040527163145 ACCESSION NUMBER: 0000878314-04-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040526 FILED AS OF DATE: 20040527 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MCPHEE MARTHA A CENTRAL INDEX KEY: 0001217668 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 04835460 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 X0202 4 2004-05-26 0 0000878314 SHOPKO STORES INC SKO 0001217668 MCPHEE MARTHA A 700 PILGRIM WAY GREENBAY WI 54304 1 0 0 0 Phantom Stock Units 2004-05-26 4 A 0 366.5689 13.64 A Common Stock 366.5689 720.9279 D Stock Option 13.64 2004-05-26 4 A 0 4000 A 2005-05-26 2014-05-25 Common Stock 4000 4000 D The Phantom Stock Units track the performance of ShopKo Stores, Inc. Common Stock. Units of Phantom Stock become payable in cash following termination of service as a director. Granted pursuant to the Company's 2004 Stock Incentive Plan for which no consideration was paid. Peter G. Vandenhoute, POA 2004-05-27 -----END PRIVACY-ENHANCED MESSAGE-----