0000899243-19-007030.txt : 20190311 0000899243-19-007030.hdr.sgml : 20190311 20190311160618 ACCESSION NUMBER: 0000899243-19-007030 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190202 FILED AS OF DATE: 20190311 DATE AS OF CHANGE: 20190311 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WEAVER DELORES B CENTRAL INDEX KEY: 0001033311 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21360 FILM NUMBER: 19672337 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: 0130 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 doc5.xml FORM 5 SUBMISSION X0306 5 2019-02-02 0 0 0 0000895447 SHOE CARNIVAL INC SCVL 0001033311 WEAVER DELORES B 7500 E. COLUMBIA STREET EVANSVILLE IN 47715 0 0 1 0 Common Stock 2018-02-27 5 G 0 1000000 0.00 D 1499922 I By Spouse Common Stock 2018-02-27 5 G 0 1000000 0.00 D 499922 I By Spouse Common Stock 2499922 D On February 27, 2018, the reporting person's spouse transferred 1,000,000 shares of common stock of Shoe Carnival, Inc. (the "Company") to the J. Wayne Weaver 2018 Grantor Retained Annuity Trust for Leigh Anne Weaver (the "Leigh Weaver GRAT"). Leigh Anne Weaver is the sole trustee of the Leigh Weaver GRAT and, as sole trustee, has sole voting and dispositive power with respect to the shares held by the Leigh Weaver GRAT. The reporting person's spouse did not retain any voting or dispositive power over the shares held by the Leigh Weaver GRAT. Reflects the three-for-two stock split of the shares of the Company's common stock, which was effected in the form of a stock dividend paid on April 27, 2012 to shareholders of record at the close of business on April 13, 2012. As a result, the reporting person and the reporting person's spouse each received 833,307 shares of the Company's common stock as of April 27, 2012. On February 27, 2018, the reporting person's spouse transferred 1,000,000 shares of the Company's common stock to the J. Wayne Weaver 2018 Grantor Retained Annuity Trust for Bradley Wayne Weaver (the "Bradley Weaver GRAT"). Bradley W. Weaver is the sole trustee of the Bradley Weaver GRAT and, as sole trustee, has sole voting and dispositive power with respect to the shares held by the Bradley Weaver GRAT. The reporting person's spouse did not retain any voting or dispositive power over the shares held by the Bradley Weaver GRAT. By: W. Kerry Jackson For: Delores B. Weaver 2019-03-11