-----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, KqQJcbkl+zqfREFTxAWSm4h4TsNqw+K5REFabGVpDa+KEn9DWPZK3FTwk35Fzihb XucizGOWTUopilLAIDR3DA== 0000892712-05-001187.txt : 20051229 0000892712-05-001187.hdr.sgml : 20051229 20051229111900 ACCESSION NUMBER: 0000892712-05-001187 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: WOLF GREGORY H CENTRAL INDEX KEY: 0001018661 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10876 FILM NUMBER: 051290327 BUSINESS ADDRESS: BUSINESS PHONE: 5025803778 MAIL ADDRESS: STREET 1: 500 WEST MAIN STREET CITY: LOUISVILLE STATE: KY ZIP: 40202 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 0001018661 WOLF GREGORY H 700 PILGRIM WAY GREEN BAY WI 54304 1 0 0 0 Common Stock 2005-12-28 4 D 0 6000 29.07 D 0 D Stock Option 31.125 2005-12-28 4 D 0 3000 D 2008-11-10 Common Stock 3000 0 D Stock Option 35.125 2005-12-28 4 D 0 2000 D 2009-05-25 Common Stock 2000 0 D Stock Option 18.19 2005-12-28 4 D 0 2000 D 2010-05-23 Common Stock 2000 0 D Stock Option 7.48 2005-12-28 4 D 0 4000 D 2011-06-04 Common Stock 4000 0 D Stock Option 19.85 2005-12-28 4 D 0 4000 D 2012-05-28 Common Stock 4000 0 D Stock Option 11.41 2005-12-28 4 D 0 4000 D 2013-05-27 Common Stock 4000 0 D Stock Option 13.64 2005-12-28 4 D 0 4000 D 2014-05-25 Common Stock 4000 0 D Phantom Stock Units 14.11 2005-12-28 4 D 0 354.359 D Common Stock 354.359 0 D Phantom Stock Units 13.64 2005-12-28 4 D 0 366.5689 D Common Stock 366.5689 0 D Includes 1,000 shares of restricted stock. 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. Units of phantom stock became payable in cash following termination of service as a director. Each phantom stock unit became payable in cash upon consummation of the merger for a payment equal to the difference between the price of the phantom stock unit and $29.07. Peter G. Vandenhouten (pursuant to power of attorney previously filed) 2005-12-28 -----END PRIVACY-ENHANCED MESSAGE-----