-----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, VT715KfYUzmh++zPtGuwVeANLrxQEITs73txJCSoRPZ7D/lq8CWs8hTxD0QHZ5G2 6Tr+9CiegEXKZYece3tE3A== 0001224120-04-000004.txt : 20040601 0001224120-04-000004.hdr.sgml : 20040531 20040601170622 ACCESSION NUMBER: 0001224120-04-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040601 FILED AS OF DATE: 20040601 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: MASSEY MICHAEL J CENTRAL INDEX KEY: 0001224120 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14770 FILM NUMBER: 04842025 BUSINESS ADDRESS: STREET 1: 3231 SE SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 BUSINESS PHONE: 7852952087 MAIL ADDRESS: STREET 1: 3231 SE SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2004-06-01 0001060232 PAYLESS SHOESOURCE INC /DE/ PSS 0001224120 MASSEY MICHAEL J 3231 S.E. SIXTH AVENUE TOPEKA KS 66607 0 1 0 0 Senior Vice President Common Stock 2004-05-28 4 A 0 1500 0 A 4840 D Employee Stock Option 2004-05-28 4 A 0 9900 15.80 A 2014-05-28 Common Stock 9900 9900 D Includes approximately 589 shares held under the Payless ShoeSource, Inc. Stock Purchase Plan. Grant of an option to buy 9,900 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 over a three-year period on May 31st of each year following the date of the grant. Michael J. Massey 2004-06-01 -----END PRIVACY-ENHANCED MESSAGE-----