-----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, La8w9I0lL4dsyRVr3nup3qLVxTsv61s0qtqAzmqNmaQriMBRWVRA6SOjjSwORmEH Fj9rOeLawqsSBlYN/XD9Mg== 0001127602-10-002668.txt : 20100129 0001127602-10-002668.hdr.sgml : 20100129 20100129155740 ACCESSION NUMBER: 0001127602-10-002668 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091226 FILED AS OF DATE: 20100129 DATE AS OF CHANGE: 20100129 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROSKOVICH CHARLES B CENTRAL INDEX KEY: 0001421786 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-00981 FILM NUMBER: 10559249 MAIL ADDRESS: STREET 1: P.O. BOX 32040 CITY: LAKELAND STATE: FL ZIP: 33802-2040 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PUBLIX SUPER MARKETS INC CENTRAL INDEX KEY: 0000081061 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 590324412 STATE OF INCORPORATION: FL FISCAL YEAR END: 1226 BUSINESS ADDRESS: STREET 1: 3300 PUBLIX CORPORATE PARKWAY CITY: LAKELAND STATE: FL ZIP: 33811 BUSINESS PHONE: 863-688-1188 MAIL ADDRESS: STREET 1: 3300 PUBLIX CORPORATE PARKWAY CITY: LAKELAND STATE: FL ZIP: 33811 5 1 form5.xml PRIMARY DOCUMENT X0303 5 2009-12-26 0 0 0000081061 PUBLIX SUPER MARKETS INC NONE 0001421786 ROSKOVICH CHARLES B P.O. BOX 407 LAKELAND FL 33802 1 Vice President Common Stock 2009-03-02 5 J 0 1210.671 16.10 A 56158.2711 I By ESOP Common Stock 2009-03-02 5 J 0 0.0019 16.10 A 30.5146 I Spouse's ESOP Common Stock 2009-03-02 5 J 0 46.5839 16.10 A 83.6285 I By 401(k) Common Stock 2009-06-12 5 J 0 46.6427 15.55 D 0 I Son's ESOP Common Stock 2009-08-03 5 J 0 0.0032 16.05 A 83.6317 I By 401(k) Common Stock 2009-08-03 5 J 0 2.1364 16.05 A 85.7681 I By 401(k) Acquired under the Publix Super Markets, Inc. 401(k) SMART Plan. Transaction exempt under rule 16b-3(c). Acquired under the Publix Super Markets, Inc. Employee Stock Ownership Plan. Transaction exempt under rule 16b-3(c). On June 12, 2009, the reporting person's son received a break-in-service and is no longer considered a participant in the Plan. /s/ Monica Allman, POA on file for Charles Roskovich 2010-01-28 -----END PRIVACY-ENHANCED MESSAGE-----