0001179110-16-020462.txt : 20160229 0001179110-16-020462.hdr.sgml : 20160229 20160229175539 ACCESSION NUMBER: 0001179110-16-020462 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160130 FILED AS OF DATE: 20160229 DATE AS OF CHANGE: 20160229 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: ORBAN GEORGE CENTRAL INDEX KEY: 0001238943 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14678 FILM NUMBER: 161470095 MAIL ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 5 1 edgar.xml FORM 5 - X0306 5 2016-01-30 0 0 0 0000745732 ROSS STORES INC ROST 0001238943 ORBAN GEORGE 5130 HACIENDA DRIVE DUBLIN CA 94568 1 0 0 0 Common Stock 2015-12-28 5 G 0 500 54.34 D 501768 D Common Stock 4383654 I Partnership Common Stock 175710 I Trust I Common Stock 97310 I Trust II Common Stock 127400 I Trust III Common Stock 97310 I Trust IV Common Stock 49000 I Trust V Common Stock 127400 I Trust VI Charitable Gift. 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. /s/John Call for George P. Orban 2016-02-29