FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION |
|
[ ] Check this box if no longer |
Washington, D.C. 20549 |
OMB Number 3235-0287 |
(Print or Type Responses) |
BENEFICIAL OWNERSHIP |
|
| 1. Name and Address of Reporting Person* Van Hall Thomas A. (Last) (First) (Middle) |
4. Statement for Month/Year August 2001 |
| 850 - 76th Street, SW (Street) |
5. If Amendment, Date of Original (Month/Year) |
| Grand Rapids Michigan 49518 (City) (State) (Zip) |
|
| 2. Issuer Name and Ticker
or Trading Symbol Spartan Stores, Inc. ("SPTN") |
6. Relationship of
Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title Other (specify below) below) Vice President Finance |
| 3. I.R.S. or Social
Security Number of Reporting Person (Voluntary) |
7. 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 Acquired, Disposed of, or Beneficially Owned |
||||||||||
| 1. Title of Security (Instr. 3) |
2. Transaction Date (Month/ Day/ Year) |
3. Transaction Code (Instr. 8) |
4. Securities
Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned at End of Month (Instr. 3 and 4) |
6. Ownership Form: Di- rect (D) or Indirect (I) (Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
||||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Common Stock |
8/1/01
|
P |
1,000
|
A |
$11.75
|
see below
|
I
|
By wife's trust
|
||
| Common Stock |
8/8/01
|
P |
1,000
|
A |
$12.10
|
4,000
|
I
|
By wife's trust
|
||
|
|
||||||||||
| Potential persons who are to respond to the collection of Information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
| Form 4 (continued) | Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
| 1. Title of Derivative
Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date (Month/ Day/ Year) |
4. Transaction Code (Instr. 8) |
5. Number
of Deriva- tive Securities Ac- quired (A) or Dis- posed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
|||
| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
|||
| 7. Title and Amount
of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Securitie(Instr. 5) | 9. Number of derivative Securities Beneficially Owned at End of Month (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
|
Title
|
Amount of Number of Shares
|
|
|||||
Explanation of Responses:
| **Intentional misstatements or omissions of facts constitute |
Thomas A. Van Hall* By: /s/ Thomas A. Van Hall* |
January 22, 2002 |
||
| Federal Criminal Violations. |
**Signature of Reporting Person
|
Date | ||
| See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
*Alex J. DeYonker
Attorney-in-Fact |
LIMITED POWER OF ATTORNEY
The undersigned does hereby constitute and appoint ALEX J. DEYONKER and TIMOTHY L. HORNER, or any one or more of them, his or her true and lawful attorneys and agents to do any and all acts and things and to execute and file any and all instruments that such attorneys and agents, or any of them, may consider necessary or advisable to enable the undersigned (in his or her individual capacity or in a fiduciary or other capacity) to comply with the Securities Exchange Act of 1934, as amended (the "Act"), and any requirements of the Securities and Exchange Commission in respect thereof, in connection with the preparation, execution and filing of any report or statement of beneficial ownership or changes in beneficial ownership of securities of SPARTAN STORES, INC. (the "Company") that the undersigned (in his or her individual capacity or in a fiduciary or other capacity) may be required to file pursuant to Sections 13 or 16 of the Act including, without limitation, full power and authority to sign the undersigned's name, in his or her individual capacity or in a fiduciary or other capacity, to any report, application or statement on Form ID, Forms 3, 4 or 5, Schedules 13D or 13G, or to any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto, hereby ratifying and confirming all that such attorneys and agents, or any of them, shall do or cause to be done by virtue hereof.
The undersigned agrees that the attorneys-in-fact named herein may rely entirely on information furnished orally or in writing by the undersigned to such attorneys-in-fact. The undersigned also agrees to indemnify and hold harmless the attorneys-in-fact against any losses, claims, damages or liabilities (or actions in respect thereof) that arise out of or are based upon any untrue statement or omission of necessary fact in the information provided by the undersigned to the attorneys-in-fact for purposes of executing, acknowledging, delivering or filing any such forms, or any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto.
This authorization shall be in addition to all
prior authorizations to act for the undersigned with respect to securities of
the Company in these matters.
|
Date: March 8, 2001 |
/s/ Thomas A. Van Hall Thomas A. Van Hall |