0001179110-13-001622.txt : 20130201 0001179110-13-001622.hdr.sgml : 20130201 20130201141548 ACCESSION NUMBER: 0001179110-13-001622 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121231 FILED AS OF DATE: 20130201 DATE AS OF CHANGE: 20130201 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: OBERTON WILLARD D CENTRAL INDEX KEY: 0001036295 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16125 FILM NUMBER: 13566127 MAIL ADDRESS: STREET 1: 2001 THEURER BLVD CITY: WINONA STATE: MN ZIP: 55987 5 1 edgar.xml FORM 5 - X0306 5 2012-12-31 0 0 0 0000815556 FASTENAL CO FAST 0001036295 OBERTON WILLARD D 2001 THEURER BOULEVARD WINONA MN 55987 1 1 0 0 CEO Common Stock 2001-12-31 5 G 0 L 80 0 D 117440 D Common Stock 2009-04-30 5 G 0 6399 0 D 224839 D Common Stock 2012-01-25 5 G 0 1800 0 D 503249 D Common Stock 2012-04-20 5 G 0 1000 0 D 502249 D Common Stock 2012-12-26 5 G 0 112500 0 D 389749 D Common Stock 2012-12-26 5 G 0 7500 0 D 129412 I Owned by Spouse Common Stock 653 I Held by 401(K) Plan The amounts reflect securities held as of 12/31/2001. The 80 shares gifted in 2001 have been incorrectly included in subsequent reports filed by the reporting person since the date of the gift and such reported shares were split in 2002, 2005 and 2011, resulting in 640 shares over-reported by the reporting person as of the end of fiscal year 2012. Amendment to a Form 5 filed for the reporting person on 2/04/2010. The amounts reflect security amounts as of 12/31/2009. The Form 5 filed on 2/04/2010 reporting the transaction on 4/30/2009 inaccurately stated the gift amount as 6400 shares, as opposed to 6399 shares. Reporting person disclaims beneficial ownership of these shares. Shares attributed to reporting person's account within issuer's 401(K) Plan as of 12/31/2012. /s/ John Milek, Attorney-in-Fact 2013-02-01