-----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, WiAthxqakF15P6aZXE2C8AXgEor9/exFuKevx+Y85l9aCKRd5uVuFUp5ZfUjkETW nPegsLQ4l6JOT1FsYSyAVg== 0001179110-04-003548.txt : 20040217 0001179110-04-003548.hdr.sgml : 20040216 20040217092457 ACCESSION NUMBER: 0001179110-04-003548 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040217 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FASTENAL CO CENTRAL INDEX KEY: 0000815556 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-BUILDING MATERIALS, HARDWARE, GARDEN SUPPLY [5200] IRS NUMBER: 410948415 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2001 THEURER BLVD CITY: WINONA STATE: MN ZIP: 55987 BUSINESS PHONE: 5074545374 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KIERLIN ROBERT A CENTRAL INDEX KEY: 0000901066 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16125 FILM NUMBER: 04603161 BUSINESS ADDRESS: STREET 1: 2001 THEURER BOULEVARD STREET 2: P O BOX 978 CITY: WINONA STATE: MN ZIP: 55987 BUSINESS PHONE: 507-454-5374 MAIL ADDRESS: STREET 1: FASTENAL CO 2001 THEURER BOULEVARD STREET 2: P O BOX 978 CITY: WINONA STATE: MN ZIP: 55987 5 1 edgar.xml FORM 5 - X0201 5 2003-12-31 0 0 0 0000815556 FASTENAL CO FAST 0000901066 KIERLIN ROBERT A 2001 THEURER BLVD. WINONA MN 55987 1 0 0 0 Call Options (obligations to sell) 27.50 1988-08-08 5 E 0 39520 0 D 2003-07-01 2003-12-31 Common Stock 39520 0 D Call Options (obligations to sell) 35.00 1988-08-08 5 E 0 95800 0 D 2004-06-01 2004-11-30 Common Stock 95800 0 D In 2000, the reporting person adopted a stock option plan for employees of the issuer and its subsidiaries (the "Plan") pursuant to which the reporting person has granted to such employees, in January 2000, January 2001 and January 2002, options to purchase shares of issuer common stock owned by the reporting person. No premium or other consideration was received by the reporting person in connection with the grant of the options. In general, each of the options granted under the Plan in January 2000 or January 2001 that had not previously expired or terminated expired on, respectively, December 31, 2002 and December 31, 2003, and each of the options granted under the Plan in January 2002 that has not previously expired or terminated will expire on November 30, 2004. Each of the options vests and becomes exercisable six months prior to the scheduled expiration date of that option. If the holder of an option ceases to be employed by the issuer or one of its subsidiaries (other than This reports the expiration of options granted under the Plan on various dates between January 1, 2003 and December 31, 2003, in each case as a result of termination of employment of the respective option holders prior to vesting of the options or, in the case of some of the options granted in January 2001, by the respective option holders failing to exercise the options before the expiration date of such options. No premium or other consideration was received by the reporting person in connection with the grant of such options. Jeffrey R. Sprain as attorney-in-fact 2004-02-16 -----END PRIVACY-ENHANCED MESSAGE-----