-----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, UcA2FUF+zzyr2Kj0ExS46Jk6AMnFoDi/pT4gqvpj0s2ZSkaBZ06O6k1HKLI/2pQY Qf1olacPmBIAtXATZnDL9Q== 0000768835-04-000025.txt : 20040304 0000768835-04-000025.hdr.sgml : 20040304 20040304165939 ACCESSION NUMBER: 0000768835-04-000025 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040219 FILED AS OF DATE: 20040304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MIERZWA DONALD A CENTRAL INDEX KEY: 0001191209 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-08897 FILM NUMBER: 04649401 BUSINESS ADDRESS: STREET 1: 300 PHILLIPI RD CITY: COLUMBUS STATE: OH ZIP: 43228 BUSINESS PHONE: 6142786800 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/A 1 edgar.xml PRIMARY DOCUMENT X0201 4/A 2004-02-19 2004-02-20 0000768835 BIG LOTS INC BLI 0001191209 MIERZWA DONALD A 300 PHILLIPI ROAD COLUMBUS OH 43228 0 1 0 0 Executive Vice President Common Stock 2004-02-19 4 A 0 410 A 3363 I By 401(k) Plan Phantom Stock Units 0 2004-02-19 4 A 0 121 15.06 A Common Stock 121 6310 D On February 19, 2004, the reporting person acquired 410 shares of common stock under the Big Lots, Inc. Savings Plan and Trust (the "401(k) Plan") as a result of the matching contribution by Big Lots, Inc. in the form of shares contemplated by the terms of the 401(k) Plan. One-for-one The reported phantom stock units were acquired under the Big Lots, Inc. Supplemental Savings Plan as a result of the matching contribution by Big Lots, Inc. in the form of shares as contemplated by the terms of the Supplemental Savings Plan. Immediately Not applicable. Represents market value per share of Big Lots, Inc.'s common stock on the date the matching contribution was calculated. Charles W. Haubiel II, attorney in fact for Donald A. Mierzwa 2004-03-04 -----END PRIVACY-ENHANCED MESSAGE-----