5 1 josefowicz5051302.htm FORM 5

FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

 
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[   ] Form 3 Holdings Reported

BENEFICIAL OWNERSHIP

 

[   ] Form 4 Transactions Reported

 

 

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility
Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940

1.    Name and Address of Reporting Person*
 
Josefowicz,                   Gregory                          P.
        (Last)                                        (First)                                   (Middle)
4.    Statement for Month/Year
 
Fiscal Year Ended
 March 30, 2002
 
 
850 - 76th Street, S.W.
 
                                                        (Street)
5.    If Amendment, Date of Original (Month/Year)
 
 
 
 
 Grand Rapids,             Michigan                49518
        (City)                                        (State)                                   (Zip)
 
2.    Issuer Name and Ticker or Trading Symbol  
 
Spartan Stores, Inc. ("SPTN")

6.    Relationship of Reporting Person(s) to Issuer
                                    (Check all applicable)
     X            Director                                          10% Owner
                  Officer (give title                            Other (specify below)
                           below)

3.    IRS or Social Security Number of Reporting Person (Voluntary)
 
 
7.    Individual or Joint/Group Reporting
                    (check applicable line)
  X      Form Filed by One Reporting Person
           Form Filed by More than One Reporting Person

 
Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
 
1. Title of Security
    (Instr. 3)
2. Transaction
    Date
    (Month/
    Day/
    Year)
3. Transaction
    Code
    (Instr. 8)
4. Securities Acquired (A) or
    Disposed of (D)
    (Instr. 3, 4 and 5)
5. Amount of
    Securities
    Beneficially
    Owned at
    end of
    Issuer's
    Fiscal Year
    (Instr. 3 and
    4)
6. Ownership
    Form: Di-
    rect (D) or
    Indirect (I)
    (Instr. 4)
7. Nature of
    Indirect
    Beneficial
    Ownership
    (Instr. 4)
      Amount (A) or (D) Price      
Common Stock
7/11/01
A
46
A
$16.25
See below
I
By wife's trust 
Common Stock
8/08/01
A
429
A
$12.23
See below
I
By wife's trust 
Common Stock
10/10/01
A
112
A
$13.33
See below
I
By wife's trust 
Common Stock
12/12/01
A
419
A
$12.51
See below
I
By wife's trust 
Common Stock
2/20/01
A
709
A
$6.34
1,915
I
By wife's trust 
               
 
                 
 
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).

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Form 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
 
1. Title of Derivative Security
    (Instr. 3)
2. Conversion
    of Exercise
    Price of
    Derivative
    Security
3. Transaction
    Date
    (Month/
    Day/
    Year)
4. Transaction
    Code
    (Instr. 8)
5. Number of Deriva-
    tive Securities Ac-
    quired (A) or Dis-
    posed of (D)
    (Instr. 3, 4, and 5)
6. Date Exercisable
    and Expiration Date
    (Month/Day/Year)
         
(A)
 
(D)
Date
Exercisable
Expiration
Date
               
               
               
               
               

7. Title and Amount of
    Underlying Securities
    (Instr. 3 and 4)
8. Price of Deriv-
    ative Security
    (Instr. 5)
9. Number of Deriv-
    ative Securities
    Beneficially owned
    at End of Year
    (Instr. 4)
10. Ownership of
      Derivative Sec-
      urity: Direct (D)
      or Indirect (I)
      (Instr. 4)
11. Nature of
      Indirect Bene-
      ficial Ownership
      (Instr. 4)
 
Title
Amount or
Number of
Shares
       
           
           
           
           
     
 
 
 
Explanation of Responses:



**Intentional misstatements or omissions of facts constitute  
s/ Gregory P. Josefowicz*      
  May 14, 2002
    Federal Criminal Violations.  
*Signature of Reporting Person
  Date
    See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).  
Gregory P. Josefowicz
*By Alex J. DeYonker
Attorney-in-Fact  
   


Note: File three copies of this Form, one of which must be manually signed.
          If space provided is insufficient, see Instruction 6 for procedure.

Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.



LIMITED POWER OF ATTORNEY

                    The undersigned does hereby constitute and appoint ALEX J. DEYONKER and TIMOTHY L. HORNER, or any one or more of them, his or her true and lawful attorneys and agents to do any and all acts and things and to execute and file any and all instruments that such attorneys and agents, or any of them, may consider necessary or advisable to enable the undersigned (in his or her individual capacity or in a fiduciary or other capacity) to comply with the Securities Exchange Act of 1934, as amended (the "Act"), and any requirements of the Securities and Exchange Commission in respect thereof, in connection with the preparation, execution and filing of any report or statement of beneficial ownership or changes in beneficial ownership of securities of SPARTAN STORES, INC. (the "Company") that the undersigned (in his or her individual capacity or in a fiduciary or other capacity) may be required to file pursuant to Sections 13 or 16 of the Act including, without limitation, full power and authority to sign the undersigned's name, in his or her individual capacity or in a fiduciary or other capacity, to any report, application or statement on Form ID, Forms 3, 4 or 5, Schedules 13D or 13G, or to any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto, hereby ratifying and confirming all that such attorneys and agents, or any of them, shall do or cause to be done by virtue hereof.

                    The undersigned agrees that the attorneys-in-fact named herein may rely entirely on information furnished orally or in writing by the undersigned to such attorneys-in-fact. The undersigned also agrees to indemnify and hold harmless the attorneys-in-fact against any losses, claims, damages or liabilities (or actions in respect thereof) that arise out of or are based upon any untrue statement or omission of necessary fact in the information provided by the undersigned to the attorneys-in-fact for purposes of executing, acknowledging, delivering or filing any such forms, or any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto.

                    This authorization shall be in addition to all prior authorizations to act for the undersigned with respect to securities of the Company in these matters.


Date: July 11, 2001

/s/ Gregory P. Josefowicz


Gregory P. Josefowicz