-----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, TwDtGa+Pi0QCNKIrxGNqoYDWNgXAzdj+Z8r5ecnpz2NJZC76kHlf51ECyCL7N49W JR2woLWV235dhk8ZmKv18Q== 0000878314-05-000001.txt : 20050120 0000878314-05-000001.hdr.sgml : 20050120 20050120144058 ACCESSION NUMBER: 0000878314-05-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050119 FILED AS OF DATE: 20050120 DATE AS OF CHANGE: 20050120 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: EUGSTER JACK W CENTRAL INDEX KEY: 0000904033 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 05538465 BUSINESS ADDRESS: STREET 1: 10400 YELLOW CIRCLE DRIVE CITY: MINNETONKA STATE: MN ZIP: 55343 BUSINESS PHONE: 6129318044 MAIL ADDRESS: STREET 1: 7075 FLYING CLOUD DR CITY: EDEN PRAIRE STATE: MN ZIP: 55344 4 1 primary_doc.xml PRIMARY DOCUMENT X0202 4 2005-01-19 0 0000878314 SHOPKO STORES INC SKO 0000904033 EUGSTER JACK W 700 PILGRIM WAY GREEN BAY WI 54304 1 0 0 1 Non-Executive Board Chairman Common Stock (Restricted) 2005-01-19 4 A 0 1000 A 16400 D Stock Option 18.35 2005-01-19 4 A 0 7000 A 2006-01-19 2015-01-18 Common Stock 7000 7000 D This stock is restricted, with vesting to occur upon the third anniversary of the grant date. Granted pursuant to one of the Company's stock incentive plans for which no consideration was paid. Includes 1,000 restricted shares. Peter G. Vandenhoute, POA 2005-01-20 -----END PRIVACY-ENHANCED MESSAGE-----