SEC Form 4 · accession 0001179110-16-030014
ROSS STORES, INC. · ROST
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James S Fassio
Officer — President, Chief Dev. Officer
Period of report
Sep 22, 2016
Accepted (ET)
Sep 26, 2016 · 1:42 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000745732
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 31, 2016 | G | 114 | $0.00 | D | 218,987 | D | |
| Common Stock | Jun 30, 2016 | G | 106 | $0.00 | D | 219,101 | D | |
| Common StockF2 | Mar 31, 2016 | G | 114 | $0.00 | A | 531,300 | I | by Trust A |
| Common StockF2 | Jun 30, 2016 | G | 106 | $0.00 | A | 531,406 | I | by Trust A |
| Common StockF2 | Sep 22, 2016 | S | 12,000 | $63.35 | D | 519,406 | I | by Trust A |
| Common StockF3 | holding | — | — | — | 129,728 | I | by Trust B |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Securities Beneficially Owned includes shares acquired pursuant to issuer's employee stock purchase plan in a transaction exempt under Rule 16b-3.
- F2Securities held in the name of James S. Fassio Revocable Trust.
- F3Securities held in the name of James S. Fassio 2012 Dynasty Irrevocable Trust.
- F4The reporting person contributed ROST common stock to an exchange fund in exchange for shares of the exchange fund in a transaction intended to comply with Rule 10b5-1(c). The ROST common stock was valued at $63.35 per share for the purposes of determining the number of shares of the exchange fund issued to the reporting person.