0001104659-15-066348.txt : 20150921 0001104659-15-066348.hdr.sgml : 20150921 20150921202912 ACCESSION NUMBER: 0001104659-15-066348 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150917 FILED AS OF DATE: 20150921 DATE AS OF CHANGE: 20150921 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ROSS STORES INC CENTRAL INDEX KEY: 0000745732 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-FAMILY CLOTHING STORES [5651] IRS NUMBER: 941390387 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 BUSINESS PHONE: 9259654400 MAIL ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FASSIO JAMES S CENTRAL INDEX KEY: 0001238932 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14678 FILM NUMBER: 151118356 MAIL ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 4 1 a4.xml 4 X0306 4 2015-09-17 0 0000745732 ROSS STORES INC ROST 0001238932 FASSIO JAMES S 5130 HACIENDA DRIVE DUBLIN CA 94568 0 1 0 0 President, Chief Dev. Officer Common Stock 2015-03-31 5 G 0 E 66 0 D 136574 D Common Stock 2015-06-30 5 G 0 E 120 0 D 273148 D Common Stock 2015-03-31 5 G 0 E 66 0 A 252565 I by Trust A Common Stock 2015-06-30 5 G 0 E 120 0 A 505250 I by Trust A Common Stock 2015-09-17 4 S 0 10055 49.7301 D 495195 I by Trust A Common Stock 2015-09-17 4 S 0 50272 49.7301 D 129728 I by Trust B The Securities Beneficially Owned reflects a 2:1 stock split effected in the form of a stock dividend paid on 6/11/2015 to all holders of record on 4/22/15. Securities held in the name of James S. Fassio Revocable Trust. Securities held in the name of James S. Fassio 2012 Dynasty Irrevocable Trust. The reporting person contributed ROST common stock to an exchange fund in exchange for shares of the exchange fund in a transaction intended to comply with Rule 10b5-1(c). The ROST common stock was valued at $49.7301 per share for the purposes of determining the number of shares of the exchange fund issued to the reporting person. Securities Beneficially Owned includes shares acquired pursuant to issuer's employee stock purchase plan in a transaction exempt under Rule 16b-3. /s/ Ken Jew for James Fassio 2015-09-21