-----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, H/T+nGFix+ttruGuy13ccU2x9IWwbjqsNRALvdfjePQm9ORDdUo5VVlpCBvCiYaB 6XkS/hfZp2JjNRUcqCVfpw== 0000878314-04-000031.txt : 20041126 0000878314-04-000031.hdr.sgml : 20041125 20041126105802 ACCESSION NUMBER: 0000878314-04-000031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041124 FILED AS OF DATE: 20041126 DATE AS OF CHANGE: 20041126 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WURL DOUGLAS N CENTRAL INDEX KEY: 0001217672 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 041168812 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 2004-11-24 0 0000878314 SHOPKO STORES INC SKO 0001217672 WURL DOUGLAS N 700 PILGRIM WAY GREENBAY WI 54304 0 1 0 0 SVP, GMM Common Stock 2004-11-24 4 M 0 3450 5.313 A 10950 D Common Stock 2004-11-24 4 M 0 600 8.29 A 11550 D Common Stock 2004-11-24 4 M 0 2000 9.12 A 13550 D Common Stock 2004-11-24 4 M 0 3334 10.1 A 16884 D Common Stock 2004-11-24 4 M 0 2500 13.78 A 19384 D Common Stock 2004-11-24 4 S 0 1165 18.58 D 18219 D Common Stock 2004-11-24 4 S 0 8800 18.52 D 9419 D Stock Option 5.313 2004-11-24 4 M 0 3450 D 2003-11-29 2010-11-28 Common Stock 3450 2300 D Stock Option 8.29 2004-11-24 4 M 0 600 D 2003-09-28 2011-09-27 Common Stock 600 400 D Stock Option 9.12 2004-11-24 4 M 0 2000 D 2003-11-28 2011-11-28 Common Stock 2000 1000 D Stock Option 10.1 2004-11-24 4 M 0 3334 D 2004-01-22 2012-01-21 Common Stock 3334 1666 D Stock Option 13.78 2004-11-24 4 M 0 2500 D 2003-12-11 2012-12-10 Common Stock 2500 5000 D Includes 7,500 shares of restricted stock granted pursuant to one of the Company's stock incentive plans. Granted pursuant to one of the Company's stock incentive plans for which no consideration was paid. Peter G. Vandenhouten, POA 2004-11-26 -----END PRIVACY-ENHANCED MESSAGE-----