0000895447-21-000019.txt : 20210315 0000895447-21-000019.hdr.sgml : 20210315 20210315160545 ACCESSION NUMBER: 0000895447-21-000019 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210130 FILED AS OF DATE: 20210315 DATE AS OF CHANGE: 20210315 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WEAVER WAYNE J CENTRAL INDEX KEY: 0001033310 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21360 FILM NUMBER: 21741521 MAIL ADDRESS: STREET 1: TWO STAMFORD PLAZA STREET 2: 281 TRESSER BLVD P O BOX 1214 CITY: STAMFORD STATE: CT ZIP: 06904-1214 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SHOE CARNIVAL INC CENTRAL INDEX KEY: 0000895447 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-SHOE STORES [5661] IRS NUMBER: 351736614 STATE OF INCORPORATION: IN FISCAL YEAR END: 0202 BUSINESS ADDRESS: STREET 1: 7500 EAST COLUMBIA STREET CITY: EVANSVILLE STATE: IN ZIP: 47715 BUSINESS PHONE: 8128676471 MAIL ADDRESS: STREET 1: 7500 EAST COLUMBIA STREET CITY: EVANSVILLE STATE: IN ZIP: 47715 5 1 edgardoc.xml PRIMARY DOCUMENT X0306 5 2021-01-30 0 0 0 0000895447 SHOE CARNIVAL INC SCVL 0001033310 WEAVER WAYNE J 7500 E. COLUMBIA STREET EVANSVILLE IN 47715 1 1 1 0 CHAIRMAN OF THE BOARD Common Stock 2020-04-27 5 G 0 1285536 0.0 A 2130954 D Common Stock 2020-04-28 5 G 0 11636 0.0 A 2142590 D Common Stock 2020-05-13 5 G 0 642768 0.0 D 1499822 D Common Stock 2020-09-08 5 G 0 106581 0.0 A 1606403 D Common Stock 2499922 I by Spouse Includes 642,768 shares of common stock of Shoe Carnival, Inc. (the "Company") that the reporting person received from the J. Wayne Weaver 2018 Grantor Retained Annuity Trust for Leigh Anne Weaver as an annuity payment on April 27, 2020, in accordance with the terms of such trust, and 642,768 shares of common stock of the Company that the reporting person received from the J. Wayne Weaver 2018 Grantor Retained Annuity Trust for Bradley Wayne Weaver (the "Bradley Weaver 2018 GRAT") as an annuity payment on April 27, 2020, in accordance with the terms of such trust. Represents shares of common stock of the Company that the reporting person reacquired from the Bradley Weaver 2018 GRAT on April 28, 2020, in accordance with the terms of such trust. Represents shares of common stock of the Company transferred by the reporting person to the J. Wayne Weaver 2020 Grantor Retained Annuity Trust for Leigh Anne Weaver (the "Leigh Weaver 2020 GRAT") on May 13, 2020. Leigh Anne Weaver is the sole trustee of the Leigh Weaver 2020 GRAT and, as sole trustee, has sole voting and dispositive power with respect to the shares held by the Leigh Weaver 2020 GRAT. The reporting person did not retain any voting or dispositive power over the shares held by the Leigh Weaver 2020 GRAT. Represents shares of common stock of the Company that the reporting person received from the J. Wayne Weaver 2019 Grantor Retained Annuity Trust for Leigh Anne Weaver as an annuity payment on September 8, 2020, in accordance with the terms of such trust. By: W. Kerry Jackson For: J. Wayne Weaver 2021-03-15