-----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, EVIFXCIZmjUfttZAaeQXVuv+QylIsA3J+m0YhS1IKx7wkl8/qrnGG+R3LumItQOQ Nn50HqaOJmjvBAG9x5l3cA== 0000768835-05-000007.txt : 20050222 0000768835-05-000007.hdr.sgml : 20050222 20050222171151 ACCESSION NUMBER: 0000768835-05-000007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050218 FILED AS OF DATE: 20050222 DATE AS OF CHANGE: 20050222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HAUBIEL CHARLES W II CENTRAL INDEX KEY: 0001191207 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08897 FILM NUMBER: 05632039 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 1 edgar.xml PRIMARY DOCUMENT X0202 4 2005-02-18 0000768835 BIG LOTS INC BLI 0001191207 HAUBIEL CHARLES W II 300 PHILLIPI ROAD COLUMBUS OH 43228 0 1 0 0 SVP, General Counsel & Sec'y Common Stock 2005-02-18 4 A 0 400 0 A 400 I By 401(k) Plan Phantom Stock 2005-02-18 4 A 0 240 0 A Common Stock 240 769 D Stock Purchase Option 11.58 2005-02-21 4 A 0 20000 0 A 2006-02-21 2015-02-20 Common Stock 20000 20000 D On February 18, 2005, the reporting person acquired the amount of common stock listed in Table I under the Big Lots, Inc. Savings Plan and Trust ("401(k) Plan") as a result of a matching contribution by the Issuer in the form of the Issuer's stock, as contemplated by the terms of the 401(k) Plan. The reporting person also holds 10,000 shares of common stock directly. One-for-one. The reported phantom stock was acquired under the Big Lots, Inc. Supplemental Savings Plan ("Supplemental Plan") as a result of the matching contribution by the Issuer in the form of the Issuer's stock, as contemplated by the terms of the Supplemental Plan. Immediately. Not applicable. The option vests in five equal annual installments beginning on February 21, 2006. The information in this report is based on plan statements dated as of February 22, 2005. Charles W. Haubiel II 2005-02-22 -----END PRIVACY-ENHANCED MESSAGE-----