-----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, WBzLSddedzJYFP8Xgs38a0FDccQX8mU7PdkjU+pIX7g1aAesLs5ro6GvRpjNdDRK QE0rutMiL0uadovKCai65w== 0000950116-05-000568.txt : 20050211 0000950116-05-000568.hdr.sgml : 20050211 20050211184258 ACCESSION NUMBER: 0000950116-05-000568 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041231 FILED AS OF DATE: 20050211 DATE AS OF CHANGE: 20050211 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: A.C. Moore Arts & Crafts, Inc. CENTRAL INDEX KEY: 0001042809 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-HOBBY, TOY & GAME SHOPS [5945] IRS NUMBER: 223527763 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 130 A.C. MOORE DRIVE CITY: BERLIN STATE: NJ ZIP: 08009 BUSINESS PHONE: (856) 768-4930 MAIL ADDRESS: STREET 1: 130 A.C. MOORE DRIVE CITY: BERLIN STATE: NJ ZIP: 08009 FORMER COMPANY: FORMER CONFORMED NAME: A C MOORE ARTS & CRAFTS INC DATE OF NAME CHANGE: 19970722 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KAPLAN WILLIAM CENTRAL INDEX KEY: 0001056330 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23157 FILM NUMBER: 05601038 BUSINESS ADDRESS: STREET 1: 302 N WATERS STREET CITY: NEWBURGH STATE: NY ZIP: 12550 BUSINESS PHONE: 9145624922 5 1 p404665_ex.xml FORM_5.XML X0202 5 2004-12-31 0 0 0 0001042809 A.C. Moore Arts & Crafts, Inc. ACMR 0001056330 KAPLAN WILLIAM 302 N WATERS STREET NEWBURGH NY 12550 1 0 1 0 Common Stock 2004-08-06 5 G 0 500162 0 D 0 D Common Stock 2000000 I By grantor retained annuity trust By virtue of the reporting person's position as investment trustee of The 2004 Wiliam Kaplan GRAT (the "2004 GRAT"), the reporting person has the power to vote and dispose of, and therefore may be deemed to be the beneficial owner of, 2,000,000 shares of A.C. Moore Arts & Crafts, Inc. common stock held in the 2004 GRAT. The filing of this Statement shall not be construed as an admission (a) that the person filing this Statement is, for the purposes of Section 16 of the Securities Exchange Act of 1934 (as amended), the beneficial owner of any equity securities covered by this Statement, or (b) that this Statement is legally required to be filed by such person. William Kaplan 2005-02-11 -----END PRIVACY-ENHANCED MESSAGE-----