-----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, KN/zhWpzaZnEUhme/BPSJ0c7xvUJ4ZX7HNJCI83mHhXptTC31V2KOx/adSal4gtN scw8OstXAWZyOQ/jyAdkVQ== 0000878314-04-000029.txt : 20040831 0000878314-04-000029.hdr.sgml : 20040831 20040831145959 ACCESSION NUMBER: 0000878314-04-000029 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040830 FILED AS OF DATE: 20040831 DATE AS OF CHANGE: 20040831 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WHITE PAUL G CENTRAL INDEX KEY: 0001267615 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 041007967 MAIL ADDRESS: STREET 1: 700 PILGRIM WAY CITY: GREEN BAY 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 2004-08-30 0 0000878314 SHOPKO STORES INC SKO 0001267615 WHITE PAUL G 700 PILGRIM WAY GREEN BAY WI 54304 0 1 0 0 SVP, Chief Merch. Officer Common Stock (Restricted) 2004-08-30 4 A 0 10000 A 12500 D Stock Option 17.1 2004-08-30 4 A 0 20000 A 2014-08-29 Common Stock 20000 20000 D This stock is restricted; the vesting schedule is 50% after the second anniversary of the grant date and 50% after the third anniversary. Granted pursuant to one of the Company's stock incentive plans for which no consideration was paid. Includes 12,500 restricted shares. The options vest over three years in equal annual installments. Peter G. Vandenhouten, POA 2004-08-31 -----END PRIVACY-ENHANCED MESSAGE-----