0001127602-17-029817.txt : 20171013 0001127602-17-029817.hdr.sgml : 20171013 20171013173605 ACCESSION NUMBER: 0001127602-17-029817 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171012 FILED AS OF DATE: 20171013 DATE AS OF CHANGE: 20171013 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROCK MACON F JR CENTRAL INDEX KEY: 0001008146 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25464 FILM NUMBER: 171137255 MAIL ADDRESS: STREET 1: 500 VOLVO PARKWAY CITY: CHESAPEAKE STATE: VA ZIP: 23320 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: 0128 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 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2017-10-12 0000935703 DOLLAR TREE INC DLTR 0001008146 BROCK MACON F JR 500 VOLVO PARKWAY CHESAPEAKE VA 23320 1 1 Chairman Emeritus Common Stock 2017-10-12 5 G 0 E 2500 0 D 750785 I Spouse Common Stock 2017-10-12 5 G 0 E 43850 0 D 1084945 D Common Stock 2017-10-13 4 M 0 63000 12.6634 A 1147945 D Common Stock 2017-10-13 4 S 0 63000 91.0355 D 1084945 D Common Stock 78677 I 2015-3 GRAT (JPB) Common Stock 78677 I 2015-3 GRAT (MFB) Common Stock 189408 I 2017-2 GRAT (JPB) Common Stock 189408 I 2017-2 GRAT (MFB) Common Stock 488790 I Trusts (Descendants') Stock Option (right to buy) 12.6634 2017-10-13 4 M 0 63000 0 D 2008-05-29 2018-05-29 Common Stock 63000 0 D Gift made without consideration. Represents the average weighted price for shares sold at a range between $90.00 and $91.0355. The filer will provide full information regarding the number of shares sold at each price upon request. Immediately exercisable. Expires upon termination, with certain grace periods, or ten years after award, whichever is less. /s/, Shawnta Totten-Medley, attorney-in-fact for Mr. Brock 2017-10-13