-----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, BYWBIHUITUl5zlIgibNnt6i/yJ884d+Ae2WL1VrBQlURZvYfasOJSpH9xnIWS2ac 96KysyzzM/ZjwMUaqzmbSQ== 0000878314-04-000017.txt : 20040528 0000878314-04-000017.hdr.sgml : 20040528 20040528112810 ACCESSION NUMBER: 0000878314-04-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040526 FILED AS OF DATE: 20040528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAWRENCE RODNEY D CENTRAL INDEX KEY: 0001217666 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 04837132 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 0001217666 LAWRENCE RODNEY D 700 PILGRIM WAY GREENBAY WI 54304 0 1 0 0 SVP, Property Development Stock Option 13.64 2004-05-26 4 A 0 10000 A 2007-05-26 2014-05-25 Common Stock 10000 10000 D The options vest over three years in equal annual installments. Granted pursuant to Company's 2004 Stock Incentive Plan for which no consideration was paid. Peter G. Vandenhouten, POA 2004-05-28 -----END PRIVACY-ENHANCED MESSAGE-----