0000892712-11-000829.txt : 20110930 0000892712-11-000829.hdr.sgml : 20110930 20110930164059 ACCESSION NUMBER: 0000892712-11-000829 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110928 FILED AS OF DATE: 20110930 DATE AS OF CHANGE: 20110930 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MANSELL KEVIN CENTRAL INDEX KEY: 0001238809 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11084 FILM NUMBER: 111117292 MAIL ADDRESS: STREET 1: C/O KOHLS LEGAL STREET 2: N56 W170000 RIDGEWOOD DR CITY: MENOMONEE FALLS STATE: WI ZIP: 53051 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: KOHLS Corp CENTRAL INDEX KEY: 0000885639 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DEPARTMENT STORES [5311] IRS NUMBER: 391630919 STATE OF INCORPORATION: WI FISCAL YEAR END: 0128 BUSINESS ADDRESS: STREET 1: N56 W17000 RIDGEWOOD DR CITY: MENOMONEE FALLS STATE: WI ZIP: 53051 BUSINESS PHONE: 4147835800 MAIL ADDRESS: STREET 1: N54 W13600 WOODALE DR CITY: MENOMONEE FALLS STATE: WI ZIP: 53051 FORMER COMPANY: FORMER CONFORMED NAME: KOHLS CORPORATION DATE OF NAME CHANGE: 19930328 4 1 edgar.xml PRIMARY DOCUMENT X0304 4 2011-09-28 0000885639 KOHLS Corp KSS 0001238809 MANSELL KEVIN N56 W17000 RIDGEWOOD DRIVE MENOMONEE FALLS WI 53051-5660 1 1 0 0 Chairman, President, CEO Common Stock 2011-09-28 4 A 0 843.12 A 245888.37 D Common Stock 138000 I By family trust Common Stock 55759 I By Trust Common Stock 55759 I By Trust for Benefit of Spouse Common Stock 6666 I By Spouse Common Stock 4628 I By children Award of additional restricted stock in lieu of a $0.25 per share dividend issued by the Company on all Common Stock, which was payable September 28, 2011. These shares vest on the same schedule as the underlying restricted shares. Includes 12,481 unvested performance shares and 161,812.37 unvested restricted shares. In accordance with SEC rules, this number does not include other forms of securities held, such as vested stock options. Mr. Mansell is not the trustee or beneficiary of the family trust. He disclaims ownership of the trust's shares for purposes of Section 16 of the Exchange Act and, accordingly, disclaims any obligation to report its transactions. This report should not be deemed an admission that the reporting person is the beneficial owner of his spouse's shares for purposes of Section 16 or any other purpose. This report should not be deemed an admission that the reporting person is the beneficial owner of his children's shares for purposes of Section 16 or any other purpose. (Richard D. Schepp P.O.A.) 2011-09-30