-----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, PHRiig6HQM8QxNdME6IXG/i5WoYkLPo6H8KbYHIvhXpj7CccIkdm636LpD3dag7Y M/cF1MAdRejwXG52N1We9Q== 0001179110-04-005935.txt : 20040312 0001179110-04-005935.hdr.sgml : 20040312 20040312162610 ACCESSION NUMBER: 0001179110-04-005935 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040131 FILED AS OF DATE: 20040312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ORBAN GEORGE CENTRAL INDEX KEY: 0001238943 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14678 FILM NUMBER: 04666434 BUSINESS ADDRESS: STREET 1: ROSS STORES INC STREET 2: 8333 CENTRAL AVENUE CITY: NEWARK STATE: CA ZIP: 94560 BUSINESS PHONE: 5105054400 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: 8333 CENTRAL AVE CITY: NEWARK STATE: CA ZIP: 94560-3433 BUSINESS PHONE: 5105054841 MAIL ADDRESS: STREET 1: 8333 CENTRAL AVENUE CITY: NEWARK STATE: CA ZIP: 94560-3433 5 1 edgar.xml FORM 5 - X0201 5 2004-01-31 0 0 0 0000745732 ROSS STORES INC ROST 0001238943 ORBAN GEORGE 8333 CENTRAL AVE NEWARK CA 94560 1 0 0 0 Common Stock 40000 D Common Stock 2003-12-29 5 G 0 1085 0 A 28385 I by Daughter Common Stock 2003-12-29 5 G 0 1085 0 A 8785 I by Daughter Sophie Common Stock 2003-12-29 5 G 0 1235 0 D 1206681 I by Partnership Common Stock 2003-12-29 5 G 0 1235 0 D 1205446 I by Partnership Common Stock 2003-12-29 5 G 0 1085 0 D 1204361 I by Partnership Common Stock 2003-12-29 5 G 0 1085 0 D 1203276 I by Partnership Common Stock 2003-12-29 5 G 0 1085 0 D 1202191 I by Partnership Common Stock 2003-12-29 5 G 0 1085 0 A 28385 I by Son Form Note: The Securities Beneficially owned on Table I reflect a 2:1 stock split effected by a stock dividend paid on 12/18/03 to all holders of record on 12/2/03. /s/ George Orban 2004-03-09 -----END PRIVACY-ENHANCED MESSAGE-----