-----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, CDccQEt3xbw71JmatShrH90ajmyu/PtNfqHn1I1vlEz6L2nOdMvWjkBC4OF+vFEP 7AQioZohOFzHi6ssh6mCiQ== 0001175748-03-000002.txt : 20030527 0001175748-03-000002.hdr.sgml : 20030526 20030527145324 ACCESSION NUMBER: 0001175748-03-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030523 FILED AS OF DATE: 20030527 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PAYLESS SHOESOURCE INC /DE/ CENTRAL INDEX KEY: 0001060232 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-SHOE STORES [5661] IRS NUMBER: 431813160 STATE OF INCORPORATION: DE FISCAL YEAR END: 0130 BUSINESS ADDRESS: STREET 1: 3231 SOUTH EAST SIXTH STREET CITY: TOPEKA STATE: KS ZIP: 66607-2207 BUSINESS PHONE: 9132335171 MAIL ADDRESS: STREET 1: 3231 S E 6TH ST CITY: TOPEKA STATE: KS ZIP: 66607-2207 FORMER COMPANY: FORMER CONFORMED NAME: PAYLESS SHOESOURCE HOLDINGS INC DATE OF NAME CHANGE: 19980421 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PORZIG ULLRICH E CENTRAL INDEX KEY: 0001175748 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14770 FILM NUMBER: 03719816 BUSINESS ADDRESS: STREET 1: 3231 S E SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 BUSINESS PHONE: 7852952087 MAIL ADDRESS: STREET 1: 3231 S E SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 4 1 edgar.xml PRIMARY DOCUMENT X0101 42003-05-23 0001060232 PAYLESS SHOESOURCE INC /DE/ PSS 0001175748 PORZIG ULLRICH E 0100Senior Vice PresidentCommon Stock2003-05-234A015000A46301ITrustEmployee Stock Option14.472003-05-234A065000A2004-05-232013-05-23Common Stock65006500DThe reporting person holds 41,094 shares indirectly in a trust account and approximately 5,207 indirectly under the Payless ShoeSource, Inc. 401(k) Plan (the "Plan") based on a statement provided by the Plan Administrator. Because the Payless Common Stock Fund under the Plan holds both cash and Payless Common Stock, the actual number of shares allocable to each participant's account varies from statement to statement. Reporting person also holds 10,590 shares directly. All share amounts have been adjusted for a three-for-one split of the Company's common stock to shareholders of record as of March 13, 2003.Grant of an option to buy 6,5 00 shares of common stock under the Payless ShoeSource, Inc. 1996 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b-3. The option vests in three equal installments on each of the first three anniversaries of the grant.Ullrich E. Porzig2003-05-23 -----END PRIVACY-ENHANCED MESSAGE-----