0001179110-22-000854.txt : 20220203 0001179110-22-000854.hdr.sgml : 20220203 20220203181241 ACCESSION NUMBER: 0001179110-22-000854 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220201 FILED AS OF DATE: 20220203 DATE AS OF CHANGE: 20220203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOBAYASHI MICHAEL K CENTRAL INDEX KEY: 0001311099 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14678 FILM NUMBER: 22590083 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: 0129 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 2022-02-01 0 0000745732 ROSS STORES, INC. ROST 0001311099 KOBAYASHI MICHAEL K 5130 HACIENDA DRIVE DUBLIN CA 94568 0 1 0 0 Pres., Chief Capability Ofcr Common Stock 2022-02-01 4 A 0 32475 0.00 A 115199 D Shares issued under the terms of the 2017 Equity Incentive Plan. Shares become vested as follows: 12,990 shares on March 20, 2026 and 19,485 shares on March 19, 2027. Securities Beneficially Owned includes 50 shares acquired on September 30, 2021 and 56 shares acquired on December 31, 2021 pursuant to issuer's employee stock purchase plan in a transaction exempt under Rule 16b-3. /s/ Ken Jew for Mike Kobayashi 2022-02-03