-----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, Iz1lZdfPNy5ti/YyUccb6eYE0iYijbqQ4GrjNb+g76e8bFxJmVzGWooqyOBFmiGM 0eGKoMeXLB2K0hIApIShHw== 0001224121-07-000002.txt : 20070402 0001224121-07-000002.hdr.sgml : 20070402 20070402121402 ACCESSION NUMBER: 0001224121-07-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070329 FILED AS OF DATE: 20070402 DATE AS OF CHANGE: 20070402 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: 7852335171 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: PAVELKA DARREL J CENTRAL INDEX KEY: 0001224121 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14770 FILM NUMBER: 07736800 BUSINESS ADDRESS: STREET 1: 3231 SE SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 BUSINESS PHONE: 7852952087 MAIL ADDRESS: STREET 1: 3231 SE SIXTH AVE CITY: TOPEKA STATE: KS ZIP: 66607 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2007-03-29 0001060232 PAYLESS SHOESOURCE INC /DE/ PSS 0001224121 PAVELKA DARREL J 3231 S.E. SIXTH AVENUE TOPEKA KS 66607 0 1 0 0 Senior Vice President Common Stock 2007-03-29 4 A 0 2175 A 12129 D Common Stock 22960 I Shares held in trust and 401(k) Stock Appreciation Right 31.115 2007-03-29 4 A 0 10400 0 A 2014-03-29 Common Stock 10400 10400 D Includes approximately 1,810 shares are held under the Payless ShoeSource, Inc. Stock Ownership Plan. The reporting person holds approximately 8,429 shares indirectly under the Payless ShoeSource, Inc. 401(k) Profit Sharing Plan (the "Plan") based on a statement provided by the Plan Administrator. Because the Common Stock Fund under the Plan holds both cash and Payless Common Stock, the actual number of shares allocable to each participant's accounts varies from statement to statement. 14,531 shares held in Trust in Spouse's Name This grant of restricted stock is subject to the following vesting conditions (i) one half of the shares will begin to vest in equal increments on May 31, 2008, May 31, 2009 and May 31, 2010 if the Company's actual store-for-store sales for fiscal 2007 is greater than 0.0 percent and (ii) the remainder of the shares will vest in equal installments over the same period set forth in (i) in an amount equal to the remainder of shares multiplied by the ratio of fiscal 2007 positive store-for-store sales divided by 3.0. For example, if the Company's actual store-for-store for fiscal 2007 is 1.5 percent, 75 percent of the shares will vest over the three year period. The stock appreciation right granted under the Payless ShoeSource, Inc. 2006 Stock Incentive Plan which provides for tax withholding rights in a transaction exempt under Rule 16b-3. The stock appreciation right vests in three equal installments over a three-year period on May 31st of each year following the date of the grant. The stock appreciation right is required to be settled in stock. Grants vest in equal increments on May 31 of 2008, 2009 and 2010 and expire 7 years from grant date. Darrel J. Pavelka 2007-04-02 -----END PRIVACY-ENHANCED MESSAGE-----