0001158449-17-000009.txt : 20170110 0001158449-17-000009.hdr.sgml : 20170110 20170110162202 ACCESSION NUMBER: 0001158449-17-000009 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170106 FILED AS OF DATE: 20170110 DATE AS OF CHANGE: 20170110 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: BERGSTROM JOHN F CENTRAL INDEX KEY: 0001196937 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-16797 FILM NUMBER: 17520807 MAIL ADDRESS: STREET 1: C/O BERGSTROM CORP STREET 2: 150 NORTH GREEN BAY RD CITY: NEENAY STATE: WI ZIP: 54956 4 1 wf-form4_148408330877421.xml FORM 4 X0306 4 2017-01-06 0 0001158449 ADVANCE AUTO PARTS INC AAP 0001196937 BERGSTROM JOHN F ADVANCE AUTO PARTS, INC. 5008 AIRPORT RD ROANOKE VA 24012 1 0 0 0 Common Stock 2017-01-06 4 A 0 4 169.63 A 16166 D These shares of issuer common stock were acquired pursuant to a dividend reinvestment feature of the Advance Auto Parts, Inc. Deferred Stock Unit Plan for Non-Employee Directors and Selected Executives. /s/ Rachel E. Geiersbach, as Attorney-in-Fact for John F. Bergstrom 2017-01-10