0001127602-16-068647.txt : 20161130 0001127602-16-068647.hdr.sgml : 20161130 20161130142746 ACCESSION NUMBER: 0001127602-16-068647 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161130 FILED AS OF DATE: 20161130 DATE AS OF CHANGE: 20161130 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOLLAR TREE INC CENTRAL INDEX KEY: 0000935703 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-VARIETY STORES [5331] IRS NUMBER: 541387365 STATE OF INCORPORATION: VA FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 500 VOLVO PARKWAY STREET 2: N/A CITY: CHESAPEAKE STATE: VA ZIP: 23320 BUSINESS PHONE: (757) 321-5000 MAIL ADDRESS: STREET 1: 500 VOLVO PARKWAY CITY: CHESAPEAKE STATE: VA ZIP: 23320 FORMER COMPANY: FORMER CONFORMED NAME: DOLLAR TREE STORES INC DATE OF NAME CHANGE: 19950117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JEWETT JOSHUA R CENTRAL INDEX KEY: 0001222823 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25464 FILM NUMBER: 162024979 MAIL ADDRESS: STREET 1: P O BOX 1017 CITY: CHARLOTTE STATE: NC ZIP: 28201-1017 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2016-11-30 0000935703 DOLLAR TREE INC DLTR 0001222823 JEWETT JOSHUA R 500 VOLVO PARKWAY CHESAPEAKE VA 23320 1 Chief Information Officer Common Stock 2016-11-30 4 M 0 1974 76.97 A 6063 D Common Stock 2016-11-30 4 M 0 2090 68.92 A 8153 D Common Stock 2016-11-30 4 M 0 1875 67.95 A 10028 D Common Stock 2016-11-30 4 S 0 434 88.6635 D 9594 D Common Stock 2016-11-30 4 S 0 5732 88.5864 D 3862 D Common Stock 2016-11-30 4 S 0 550 88.2943 D 3312 D Stock Option (right to buy) 76.97 2016-11-30 4 M 0 1974 0 D 2024-10-14 Common Stock 1974 2961 D Stock Option (right to buy) 68.92 2016-11-30 4 M 0 2090 0 D 2018-10-15 Common Stock 2090 2089 D Stock Option (right to buy) 67.95 2016-11-30 4 M 0 1875 0 D 2017-10-09 Common Stock 1875 0 D Represents the weighted average price for shares sold at the range between $88.5833 and $88.6. The filer will provide full information regarding the number of shares sold at each price upon request. Pursuant to the Merger Agreement dated July 6, 2015, each option to purchase shares of Family Dollar common stock that was outstanding immediately prior to the Effective Time was converted into an option to purchase a number of shares of Dollar Tree common stock determined by multiplying the number of shares of Family Dollar common stock subject to such option by the Award Exchange Ratio of 1.000, at an exercise price per share determined by dividing the orginal per share exercise price of the option by the Award Exchange Ratio of 1.000. Award granted on October 14, 2014. Each option becomes exercisable with respect to 40% of the underlying shares on the second anniversary of grant and with respect to an additional 30% on each of the third and fourth anniversaries of grant. Award was granted on October 15, 2013. Award granted on October 9, 2012. /s/ Shawnta Totten-Medley, attorney-in-fact for Mr. Jewett 2016-11-30