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SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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1. Name and Address of Reporting Person*
JOHNSON TIMOTHY A

(Last) (First) (Middle)
300 PHILLIPI ROAD

(Street)
COLUMBUS OH 43228

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/03/2004
3. Issuer Name and Ticker or Trading Symbol
BIG LOTS INC [ BLI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP, Strategic Plan/Investor Re
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
401(k) Holdings 1,682(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Purchase Option 08/21/2001(2) 08/21/2010 Common Stock 5,000 14.06 D
Stock Purchase Option 03/05/2002(2) 03/05/2011 Common Stock 3,500 11.74 D
Stock Purchase Option 02/25/2003(2) 02/25/2012 Common Stock 2,500 11.98 D
Stock Purchase Option 02/24/2004(2) 02/24/2013 Common Stock 3,500 10.85 D
Stock Purchase Option 02/02/2005(2) 02/02/2014 Common Stock 20,000 14.28 D
Explanation of Responses:
1. Interest in securities held in the Company's Savings Plan ("401(k)").
2. Dates in this column reflect the first of five annual vesting dates upon which 20% of the Stock Purchase Option becomes exercisable.
Remarks:
Charles W. Haubiel II, attorney in fact for Timothy A. Johnson 02/05/2004
** Signature of Reporting Person Date
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 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
SPECIAL POWER OF ATTORNEY



THE UNDERSIGNED, Timothy A. Johnson, presently residing at 5526 Long Cove Court, Westerville, Ohio  43082, does hereby appoint Albert J. Bell, Charles W. Haubiel and Chadwick P. Reynolds, respectively and each of them, and each of them having full power of substitution for the other, as his lawful attorney-in-fact, and hereby empowers each of them to act singly or in concert for the limited purpose of preparing, executing and filing on behalf of the undersigned any registration statement, prospectus, underwriting agreement, and all periodic reports required to be filed either he or by Big Lots, Inc. on Form 10-K, Form 10-Q, Form 8-K, Form 3, Form 4, Form 5, Form 144, or such other form as may be required, respectively as the case may be, with the Securities and Exchange Commission and with any securities exchange on which such security is listed or traded, as may from time-to-time be required pursuant to the Securities Act of 1933 as amended, the Securities Exchange Act of 1934 as amended, or the rules which
 are promulgated from time-to-time under either of such Acts, or the rules of any securities exchange.



This Special Power of Attorney is limited to the specific acts herein described and is made effective the date last below written, and shall continue in full force and effect until revoked by the undersigned.  This Special Power of Attorney, and the appointment and empowerment herein made, shall not be deemed revoked or superseded, or otherwise affected, by the illness, incapacity or death of the undersigned until such time as the earlier occurring of either (i) a period of one year shall have elapsed from the date of such illness, incapacity or death, or (ii) the receipt by each of the above named appointees of a writing which revokes this Special Power of Attorney issued by the lawful Personal Representative, Custodian or Conservator, of the undersigned.



/s/ Timothy A. Johnson

TIMOTHY A. JOHNSON



STATE OF OHIO)

) ss

COUNTY OF FRANKLIN)



BEFORE ME, the undersigned Notary Public in and for said county and state, did personally appear on this 4th day of February, 2004, the above-signed individual known to me to be Timothy A. Johnson, and upon oath duly sworn did testify that the signing of the above and foregoing instrument did constitute his free and voluntary act and deed.



/s/ Leshell L. Duncan

NOTARY PUBLIC

[SEAL]

My Commission expires:  12-21-2008