-----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, N9Xd93D3HBWQgw/mV+J+iwWS5sQliHQUtvoyj1jMI2V5q3lWmx19tJ8rUnkv4wA/ xODLJAiQhoy6Ks7+NT3dvQ== 0000768835-03-000005.txt : 20030829 0000768835-03-000005.hdr.sgml : 20030829 20030829111209 ACCESSION NUMBER: 0000768835-03-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030828 FILED AS OF DATE: 20030829 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOLLAT DAVID T CENTRAL INDEX KEY: 0001015790 STANDARD INDUSTRIAL CLASSIFICATION: FOOTWEAR, (NO RUBBER) [3140] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08897 FILM NUMBER: 03872873 BUSINESS ADDRESS: STREET 1: C/O 22, INC. STREET 2: 4410 SMOTHERS ROAD CITY: WESTERVILLE STATE: OH ZIP: 43081 BUSINESS PHONE: 6145230041 MAIL ADDRESS: STREET 1: 9341 COURTLAND DR CITY: ROCKFORD STATE: MI ZIP: 49351 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIG LOTS INC CENTRAL INDEX KEY: 0000768835 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-VARIETY STORES [5331] IRS NUMBER: 061119097 STATE OF INCORPORATION: OH FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 300 PHILLIPI ROAD STREET 2: P.O.BOX 28512 CITY: COLUMBUS STATE: OH ZIP: 43228-0512 BUSINESS PHONE: 614-278-6800 MAIL ADDRESS: STREET 1: 300 PHILLIPI ROAD STREET 2: P.O.BOX 28512 CITY: COLUMBUS STATE: OH ZIP: 43228-0512 4 1 edgar.xml PRIMARY DOCUMENT X0201 42003-08-28 0000768835 BIG LOTS INC BLI 0001015790 KOLLAT DAVID T 4410 SMOTHERS ROAD WESTERVILLE OH 43081 1000Common Stock2003-08-284M0781310.88A91408DStock Purchase Option10.882003-08-284M078130A1994-09-092003-10-09Common Stock781358439DOne stock purchase option representing 7,813 underlying shares of common stock.Nine stock purchase options representing 58,439 underlying shares of common stock.Charles W. Haubiel II, attorney in fact for David T. Kollat2003-08-29 -----END PRIVACY-ENHANCED MESSAGE-----