5 1 0001.txt FORM 5 FOR CAL H. TURNER JR. U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported ________________________________________________________________________________ 1. Name and Address of Reporting Person* Turner, Cal Hr. Jr., -------------------------------------------------------------------------------- (Last) (First) (Middle) 100 Mission Ridge -------------------------------------------------------------------------------- (Street) Goodlettsville, TN 37072 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Dollar General Corporation DG ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year January 2001 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] 10% Owner [X] Officer (give title below) [_] Other (specify below) Chairman of the Board & CEO ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [_] Form filed by more than one Reporting Person ________________________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship Disposed of (D) Beneficially Form: 7. (Instr. 3, 4 and 5) Owned at End Direct Nature of 2. 3. ----------------------------- of Issuer's (D) or Indirect 1. Transaction Transaction (A) Fiscal Year Indirect Beneficial Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (Instr. 8) (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 5,156,001 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 10,265 D IRA ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 727,587 I Spouse ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 2,826,456 I TTEE TF FDN ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 50,065,030 I COTTEE TCT ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,293,620 I COTTEE HCT TR ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,531,180 I COTTEE JST TR ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,881,036 I COTTEE LJTD TR ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,881,513 I COTTEE ECT TR ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 142,907 I COTTEE HCT 99 ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 272,779 I COTTEE DUGAS TR ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 43,743 I COTTEE LJD FDN ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 98,058 I COTTEE LWC FDN ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 82 J COTTEE CTS ESTATE ------------------------------------------------------------------------------------------------------------------------------------ Common Stock ====================================================================================================================================
* If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) (Over) (Form 5-07/99) FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ----------------------------------------------------------------------------------------------------------------------------------- Stock Option 17.75 4/20/00 A 228,879 4/20/00 4/20/00 Common 228,878 228,878 D Stock ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 17.312 9/27/00 A 71,525 9/27/00 9/27/00 Common 71,525 71,525 D Stock ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: Cal H. Turner Jr. 3/19/2001 --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Page 2