FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/07/2008 |
3. Issuer Name and Ticker or Trading Symbol
BIG LOTS INC [ BLI ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 2,500 | D | |
Common Stock | 574 | I | By 401(k) Plan(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Purchase Option | 02/24/2007(2) | 02/24/2013 | Common Stock | 5,625 | $12.66 | D | |
Stock Purchase Option | 03/13/2008(2) | 03/13/2014 | Common Stock | 7,500 | $28.73 | D | |
Phantom Stock | (3) | (4) | Common Stock | 82(5) | (6) | D |
Explanation of Responses: |
1. Common stock held under the Big Lots Savings Plan ("401(k)"). This information is based on a 401(k) Plan report dated January 7, 2008. |
2. The date upon which the first of four equal annual installments was or becomes exercisable. |
3. Immediately. |
4. Not applicable. |
5. The reported phantom stock is held under the Big Lots Supplemental Savings Plan. This information is based on a plan report dated January 7, 2008. |
6. One-for-one. |
Remarks: |
Chadwick P. Reynolds, attorney in fact for Robert Samuel Segal | 01/17/2008 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |