-----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, BktmNGAgqgYhL9i3rSsRsU3BWEbEagSo/oAiMaGASKy3onifIJ8DYIPMyY3HYPIm eN/Y1c47g5MWj/cnRffkLw== 0000892712-05-001186.txt : 20051229 0000892712-05-001186.hdr.sgml : 20051229 20051229111822 ACCESSION NUMBER: 0000892712-05-001186 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051228 FILED AS OF DATE: 20051229 DATE AS OF CHANGE: 20051229 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: 051290325 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: 0129 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 edgar.xml PRIMARY DOCUMENT X0202 4 2005-12-28 1 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) 2005-12-28 4 D 0 12500 29.07 D 0 D Stock Option 15.32 2005-12-28 4 D 0 10000 D 2013-11-18 Common Stock 10000 0 D Stock Option 13.64 2005-12-28 4 D 0 7500 D 2014-05-25 Common Stock 7500 0 D Stock Option 17.10 2005-12-28 4 D 0 20000 D 2014-08-29 Common Stock 20000 0 D Disposed of pursuant to Agreement and Plan of Merger by and among issuer and SKO Group Holding Corp. and SKO Acquisition Corp. in exchange for a cash payment of $29.07 per share. Each stock option of the issuer became exercisable in full upon consummation of the merger and was cancelled in the merger in exchange for a cash payment per share equal to the difference between the exercise price of the option and $29.07. Peter G. Vandenhouten (pursuant to power of attorney previously filed) 2005-12-28 -----END PRIVACY-ENHANCED MESSAGE-----