0001158449-16-000441.txt : 20160705
0001158449-16-000441.hdr.sgml : 20160705
20160705162618
ACCESSION NUMBER: 0001158449-16-000441
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160701
FILED AS OF DATE: 20160705
DATE AS OF CHANGE: 20160705
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ADVANCE AUTO PARTS INC
CENTRAL INDEX KEY: 0001158449
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO & HOME SUPPLY STORES [5531]
IRS NUMBER: 542049910
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0102
BUSINESS ADDRESS:
STREET 1: 5008 AIRPORT RD
CITY: ROANOKE
STATE: VA
ZIP: 24012
BUSINESS PHONE: 5403624911
MAIL ADDRESS:
STREET 1: 5008 AIRPORT RD
CITY: ROANOKE
STATE: VA
ZIP: 24012
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Brouillard John C.
CENTRAL INDEX KEY: 0001291909
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16797
FILM NUMBER: 161750792
MAIL ADDRESS:
STREET 1: P.O. BOX 839999
STREET 2: 646 SOUTH MAIN AVENUE
CITY: SAN ANTONIO
STATE: TX
ZIP: 78283-3999
4
1
wf-form4_146775036496055.xml
FORM 4
X0306
4
2016-07-01
0
0001158449
ADVANCE AUTO PARTS INC
AAP
0001291909
Brouillard John C.
ADVANCE AUTO PARTS, INC.
5008 AIRPORT RD
ROANOKE
VA
24012
1
0
0
0
Common Stock
2016-07-01
4
A
0
5
164.33
A
27418
D
Common Stock
857
I
By grantor retained annuity trust
These shares of issuer common stock were acquired puruant to a dividend reinvestment feature of the Advance Auto Parts, Inc. Deferred Stock Unit Plan for Non-Employee Directors and Selected Executives.
On September 15, 2014, the reporting person contributed 7,500 shares of Advance Auto Parts, Inc. common stock to a grantor retained annuity trust (GRAT). The reporting person is the sole trustee and annuitant during the term of the GRAT. On August 18, 2015 and September 21, 2015, the reporting person received a distribution from the GRAT of 5,000 and 1,643 shares, respectively.
/s/ Rachel E. Geiersbach, as Attorney-in-Fact for John C. Brouillard
2016-07-05