0000892712-11-001034.txt : 20111230 0000892712-11-001034.hdr.sgml : 20111230 20111230111854 ACCESSION NUMBER: 0000892712-11-001034 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111228 FILED AS OF DATE: 20111230 DATE AS OF CHANGE: 20111230 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SICA FRANK V CENTRAL INDEX KEY: 0001186223 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11084 FILM NUMBER: 111288284 MAIL ADDRESS: STREET 1: CSG SYSTEMS INTERNATIONAL INC STREET 2: 7887 E BELLEVIEW AVE STE 1000 CITY: ENGEWOOD STATE: CO ZIP: 801111 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: 0131 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 2011-12-28 0000885639 KOHLS Corp KSS 0001186223 SICA FRANK V N56 W17000 RIDGEWOOD DRIVE MENOMONEE FALLS WI 53051-5660 1 0 0 0 Common Stock 2011-12-28 4 A 0 4.53 A 12845.71 D Common Stock 19628 I By spouse and trust Common Stock 1000 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 December 28, 2011. These shares vest on the same schedule as the underlying restricted shares. Includes 911.71 unvested shares of restricted stock. This amount represents 14,628 shares held for the account of the Reporting Person's spouse and 5,000 shares held by a trust for the Reporting Person's children for which Reporting Person's spouse serves as a trustee. The filing of this report shall not be deemed an admission that Mr. Sica is the beneficial owner of these shares for purposes of Section 16 of the Exchange Act of 1934. The filing of this report shall not be deemed an admission that Mr. Sica is the beneficial owner of these shares for purposes of Section 16 of the Exchange Act of 1934. (Richard D. Schepp P.O.A.) 2011-12-30