0001179110-21-003757.txt : 20210323 0001179110-21-003757.hdr.sgml : 20210323 20210323201847 ACCESSION NUMBER: 0001179110-21-003757 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210319 FILED AS OF DATE: 20210323 DATE AS OF CHANGE: 20210323 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BALMUTH MICHAEL CENTRAL INDEX KEY: 0001238922 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14678 FILM NUMBER: 21766208 MAIL ADDRESS: STREET 1: 5130 HACIENDA DRIVE CITY: DUBLIN STATE: CA ZIP: 94568 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: 0130 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 FORMER COMPANY: FORMER CONFORMED NAME: ROSS STORES INC DATE OF NAME CHANGE: 19920703 4 1 edgar.xml FORM 4 - X0306 4 2021-03-19 0 0000745732 ROSS STORES, INC. ROST 0001238922 BALMUTH MICHAEL 5130 HACIENDA DRIVE DUBLIN CA 94568 1 1 0 0 Chairman of the Board Common Stock 2021-03-19 4 A 0 39520 0 A 61951 D Common Stock 2021-03-19 4 S 0 11856 121.3642 D 50095 D Shares issued pursuant to settlement of a performance share award under the terms of the 2017 Equity Incentive Plan. Shares become vested as follows: 11,856 shares vest as of March 19, 2021 and 27,664 shares vest as of May 28, 2021. Shares were sold pursuant to the terms of a pre-established 10b5-1 Plan established on September 18, 2020. The price reported is a weighted average price. The shares were sold in multiple transactions at prices ranging from $119.68 to $122.63, inclusive. The reporting person undertakes to provide to Ross Stores, Inc., any security holder of Ross Stores, Inc., and to the staff of the Securities and Exchange Commission upon request, full information regarding the numbers of shares sold at each separate price within this price range. /s/ Ken Jew for Michael Balmuth 2021-03-23