-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, QSAGpGsnNSWVnJB/hlV5MNd1KSzhsAyxTu94vzrJsRkQGoyaT4b6tHXPmtqdDvmo xreJ9EWtzGj34GmjzABnBA== 0001045969-03-000325.txt : 20030213 0001045969-03-000325.hdr.sgml : 20030213 20030213104706 ACCESSION NUMBER: 0001045969-03-000325 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20030213 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FASTENAL CO CENTRAL INDEX KEY: 0000815556 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-BUILDING MATERIALS, HARDWARE, GARDEN SUPPLY [5200] IRS NUMBER: 410948415 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-39118 FILM NUMBER: 03557081 BUSINESS ADDRESS: STREET 1: 2001 THEURER BLVD CITY: WINONA STATE: MN ZIP: 55987 BUSINESS PHONE: 5074545374 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KIERLIN ROBERT A CENTRAL INDEX KEY: 0000901066 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 2001 THEURER BOULEVARD STREET 2: P O BOX 978 CITY: WINONA STATE: MN ZIP: 55987 BUSINESS PHONE: 507-454-5374 MAIL ADDRESS: STREET 1: FASTENAL CO 2001 THEURER BOULEVARD STREET 2: P O BOX 978 CITY: WINONA STATE: MN ZIP: 55987 SC 13G/A 1 dsc13ga.txt SCHEDULE 13G AMENDMENT NO. 15 ---------------------------------- OMB APPROVAL ---------------------------------- OMB Number: 3235-0145 Expires: December 31, 2005 Estimated average burden hours per response 11 ---------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 15)* Fastenal Company -------------------------------------------------------- (Name of Issuer) Common Stock -------------------------------------------------------- (Title of Class of Securities) 311900104 -------------------------------------------------------- (CUSIP Number) December 31, 2002 -------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [_] Rule 13d-1(b) [_] Rule 13d-1(c) [X] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. SEC 1745 (3-98) Page 1 of 5 - ------------------- CUSIP No. 311900104 13G - ---------- -------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Robert A. Kierlin - ---------- -------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [_] Not Applicable (b) [_] - ---------- -------------------------------------------------------------------- 3 SEC USE ONLY - ---------- -------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - ---------- -------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF 6,738,342 SHARES --------- ----------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 200 EACH --------- ----------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON 6,738,342 WITH: --------- ----------------------------------------- 8 SHARED DISPOSITIVE POWER 200 - ---------- -------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 6,738,542 - ---------- -------------------------------------------------------------------- 10 CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*|_| Not Applicable - ---------- -------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 8.9% - ---------- -------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - ---------- -------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! Page 2 of 5 Item 1. (a) Name of Issuer Fastenal Company (b) Address of Issuer's Principal Executive Offices 2001 Theurer Boulevard Winona, Minnesota 55987-1500 Item 2. (a) Name of Person Filing This filing is made by Robert A. Kierlin (b) Address of Principal Business Office or, if none, Residence Robert A. Kierlin Fastenal Company 2001 Theurer Boulevard Winona, Minnesota 55987-1500 (c) Citizenship Robert A. Kierlin is a citizen of the United States (d) Title of Class of Securities Common Stock, $.01 par value (e) CUSIP Number 311900104 Item 3. If this statement is filed pursuant to ss.ss. 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a: (a) [_] Broker or dealer registered under Section 15 of the Act. (b) [_] Bank as defined in Section 3(a)(6) of the Act. (c) [_] Insurance company as defined in Section 3(a)(19) of the Act. (d) [_] Investment company registered under Section 8 of the Investment Company Act of 1940. (e) [_] An investment adviser in accordance with ss.240.13d-1(b)(1)(ii)(E). (f) [_] An employee benefit plan or endowment fund in accordance with ss. 240.13d-1(b)(1)(ii)(F). (g) [_] A parent holding company or control person in accordance with ss. 240.13d-1(b)(1)(ii)(G). (h) [_] A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act. (i) [_] A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act of 1940. (j) [_] Group, in accordance with ss. 240.13d-1(b)(1)(ii)(J). Not Applicable Page 3 of 5 Item 4. Ownership (a) Amount Beneficially Owned 6,738,542 (b) Percent of Class 8.9% (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote 6,738,342 (ii) Shared power to vote or to direct the vote 200 (iii) Sole power to dispose or to direct the disposition of 6,738,342 (iv) Shared power to dispose or to direct the disposition of 200 See Item 6 for further information regarding the nature of the reporting person's beneficial ownership of certain of the above-referenced shares. Item 5. Ownership of Five Percent or Less of a Class If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [_]. Not Applicable Item 6. Ownership of More than Five Percent on Behalf of Another Person. The shares listed in Item 4 include 200 shares held by the reporting person's wife. The reporting person disclaims beneficial ownership of such shares. The reporting person's wife has the right to receive and the power to direct the receipt of dividends from, and the proceeds of the sale of, the shares held by her. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company Not Applicable Item 8. Identification and Classification of Members of the Group Not Applicable Item 9. Notice of Dissolution of Group Not Applicable Item 10. Certification Not Applicable Page 4 of 5 SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. December 31, 2002 ----------------------------------------- Date /s/ Robert A. Kierlin ----------------------------------------- Signature Robert A. Kierlin ----------------------------------------- Name/Title The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative other than an executive officer or general partner of the filing person, evidence of the representative's authority to sign on behalf of such person shall be filed with the statement, provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath his signature. NOTE: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. Seess. 240.13d-7 for other parties for whom copies are to be sent. Attention: Intentional misstatements or omissions of fact constitute Federal criminal violations (See 18 U.S.C. 1001). Page 5 of 5 -----END PRIVACY-ENHANCED MESSAGE-----