0001127602-12-026823.txt : 20120921
0001127602-12-026823.hdr.sgml : 20120921
20120921152630
ACCESSION NUMBER: 0001127602-12-026823
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120920
FILED AS OF DATE: 20120921
DATE AS OF CHANGE: 20120921
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jacobs David A.
CENTRAL INDEX KEY: 0001546549
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-25464
FILM NUMBER: 121104163
MAIL ADDRESS:
STREET 1: 500 VOLVO PARKWAY
CITY: CHESAPEAKE
STATE: VA
ZIP: 23320
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: DOLLAR TREE INC
CENTRAL INDEX KEY: 0000935703
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-VARIETY STORES [5331]
IRS NUMBER: 541387365
STATE OF INCORPORATION: VA
FISCAL YEAR END: 0128
BUSINESS ADDRESS:
STREET 1: 500 VOLVO PARKWAY
STREET 2: N/A
CITY: CHESAPEAKE
STATE: VA
ZIP: 23320
BUSINESS PHONE: (757) 321-5000
MAIL ADDRESS:
STREET 1: 500 VOLVO PARKWAY
CITY: CHESAPEAKE
STATE: VA
ZIP: 23320
FORMER COMPANY:
FORMER CONFORMED NAME: DOLLAR TREE STORES INC
DATE OF NAME CHANGE: 19950117
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2012-09-20
0000935703
DOLLAR TREE INC
DLTR
0001546549
Jacobs David A.
500 VOLVO PARKWAY
CHESAPEAKE
VA
23320
1
Chief Strategy Officer
Common Stock
2012-09-20
4
M
0
18750
8.91
A
32776
D
Common Stock
2012-09-20
4
M
0
8750
12.7467
A
41526
D
Common Stock
2012-09-20
4
S
0
27500
49.2365
D
14026
D
Stock Option (right to buy)
8.91
2012-09-20
4
M
0
18750
0
D
2009-03-14
2018-03-14
Common Stock
18750
0
D
Stock Option (right to buy)
12.7467
2012-09-20
4
M
0
8750
0
D
2008-03-30
2017-03-30
Common Stock
8750
0
D
Represents the weighted average price for shares sold at the range between $49.21 and $49.265. The filer will provide full information regarding the number of shares sold at each price upon request.
Vests in three approximately equal annual installments, beginning the first anniversary of the award date, subject to continued employment.
Expires at the earlier of one year after ceasing to be a director, with certain grace periods, or ten years after grant.
/s/ Shawnta Totten, attorney-in-fact for David A. Jacobs
2012-09-21