-----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, JCGMw4viD2E4bkNOLSCO82DDrhqShDyQrhG4XJs77ZE2OIEyH2qV/VjrwWBD9q1c ElMdhknHyqpcxj3Sb99Zyg== 0000768835-04-000036.txt : 20040803 0000768835-04-000036.hdr.sgml : 20040803 20040803135650 ACCESSION NUMBER: 0000768835-04-000036 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040802 FILED AS OF DATE: 20040803 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: 04947746 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 X0202 4 2004-08-02 0000768835 BIG LOTS INC BLI 0001015790 KOLLAT DAVID T 4410 SMOTHERS ROAD WESTERVILLE OH 43081 1 0 0 0 Common Stock 2004-08-02 4 M 0 7813 10.48 A 99221 D Stock Purchase Option 10.48 2004-08-02 4 M 0 7813 0 D 2004-10-09 Common Stock 7813 60626 D One Stock Purchase Option representing 7,813 underlying shares of Common Stock. The Stock Purchase Option vested over the first three years beginning on the first anniversary of the grant date, September 9, 1994, whereby it becomes exercisable for 20% of the shares on the first anniversary, 60% on the second anniversary, and 100% on the third anniversary. Nine Stock Purchase Options representing 60,626 underlying shares of Common Stock. Charles W. Haubiel II, attorney in fact for David T. Kollat 2004-08-03 -----END PRIVACY-ENHANCED MESSAGE-----