-----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, AbXq4kH2FGJ4c3ZGAiHi1X1VmjxnKaxaWBi5mJMWEfUY1hY9TU7zm1wPqLN3iXPV Pk9ncoDLUpBnk8BNYiTwYw== 0000897069-99-000081.txt : 19990217 0000897069-99-000081.hdr.sgml : 19990217 ACCESSION NUMBER: 0000897069-99-000081 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19990216 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SCHULTZ SAV O STORES INC CENTRAL INDEX KEY: 0000087588 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 390600405 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-30505 FILM NUMBER: 99539760 BUSINESS ADDRESS: STREET 1: 2215 UNION AVE CITY: SHEBOYGAN STATE: WI ZIP: 53081 BUSINESS PHONE: 4144574433 MAIL ADDRESS: STREET 1: 2215 UNION AVE CITY: SHEBOYGAN STATE: WI ZIP: 53081 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SCHULTZ SAV O STORES RETIREMENT SAVINGS PLAN CENTRAL INDEX KEY: 0000927288 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 2215 UNION AVE CITY: SHEBOYGAN STATE: WI ZIP: 53081 BUSINESS PHONE: 4144574433 MAIL ADDRESS: STREET 1: 2215 UNION AVE CITY: SHEBOYGAN STATE: WI ZIP: 53081 FORMER COMPANY: FORMER CONFORMED NAME: SCHULTZ SAV O STORES INC SALARIED EMPLOYEES PROFIT SHARING T DATE OF NAME CHANGE: 19940721 SC 13G/A 1 SCHEDULE 13G AMENDMENT SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 14)* SCHULTZ SAV-O STORES, INC. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $.05 par value - -------------------------------------------------------------------------------- (Title of Class of Securities) 808196 10 9 -------------------------------------------------- (CUSIP Number) December 31, 1998 -------------------------------------------------- (Date of Event Which Requires Filing of this Statement Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(d) * The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). (Continued on following page(s)) Page 1 of 3 Pages - ------------------------- CUSIP No. 808196 10 9 - ------------------------- =============================================================================== 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Schultz Sav-O Stores Retirement Savings Plan (f/k/a Schultz Sav-O Stores Salaried Employees' Profit Sharing Trust) ================================================================================ 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) [ ] (b) [ ] N/A ================================================================================ 3 SEC USE ONLY ================================================================================ 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States ================================================================================ 5 SOLE VOTING POWER NUMBER OF 0 SHARES ============================================================= 6 SHARED VOTING POWER BENEFICIALLY 1,156,866.352 OWNED BY ============================================================= 7 SOLE DISPOSITIVE POWER EACH 0 REPORTING ============================================================= 8 SHARED DISPOSITIVE POWER PERSON 1,156,866.352 WITH ================================================================================ 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,156,866.352 ================================================================================ 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) [ ] N/A ================================================================================ 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 17.54% ================================================================================ 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) EP ================================================================================ Page 2 of 3 Pages - -------------------------- CUSIP No. 808196 10 9 - -------------------------- This Amendment No. 14 to Schedule 13G with regard to Schultz Sav-O Stores, Inc. is being filed on behalf of the undersigned to amend Item 4 of the originally filed Schedule 13G. Except as expressly stated herein, there have been no material changes in the information set forth in the Schedule 13G. Item 4. Ownership (as of December 31, 1998): (a) Amount Beneficially Owned: 1,156,866.352 (b) Percent of Class: 17.54% (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 0 (ii) shared power to vote or to direct the vote: 1,156,866.352 Shares (iii) sole power to dispose or to direct the disposition of: 0 (iv) shared power to dispose or to direct the disposition of: 1,156,866.352 Shares SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 11, 1999 Date SCHULTZ SAV-O STORES RETIREMENT SAVINGS PLAN f/k/a Schultz Sav-O Stores Salaried Employees' Profit Sharing Trust) By: /s/ John H. Dahly John H. Dahly Co-Administrator -----END PRIVACY-ENHANCED MESSAGE-----