FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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OMB APPROVAL
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1. Name and Address of Reporting Person
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KKR Fund Holdings GP Ltd |
2. Issuer Name
and
Ticker or Trading Symbol
DOLLAR GENERAL CORP [ DG ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __ X __ 10% Owner _____ Officer (give title below) _____ Other (specify below) |
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P., 9 WEST 57TH STREET, SUITE 4200 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
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NEW YORK, NY 10019 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person _ X _ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of Security
(Instr. 3) |
2. Trans. Date | 2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock, par value $0.875 per share | 10/10/2012 | S | 1987537 | D | $50.715 (1) | 26177298 | I | Held through Buck Holdings, L.P. and KKR 2006 Fund L.P. (2) (3) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/11/2012 | J (4) | 1811269 | D | $50.715 (4) | 24366029 | I | Held through Buck Holdings, L.P. and KKR 2006 Fund L.P. (2) (3) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/10/2012 | S | 419430 | D | $50.715 (1) | 5524198 | I | Held through Buck Holdings, L.P. and KKR PEI Investments, L.P. (2) (5) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/11/2012 | J (4) | 382232 | D | $50.715 (4) | 5141966 | I | Held through Buck Holdings, L.P. and KKR PEI Investments, L.P. (2) (5) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/10/2012 | S | 68992 | D | $50.715 (1) | 908678 | I | Held through Buck Holdings, L.P. and 8 North America Investor L.P. (2) (6) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/11/2012 | J (4) | 62874 | D | $50.715 (4) | 845804 | I | Held through Buck Holdings, L.P. and 8 North America Investor L.P. (2) (6) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/10/2012 | S | 295105 | D | $50.715 (1) | 3886748 | I | Held through Buck Holdings, L.P. and Buck Holdings Co-Invest, L.P. (2) (7) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/11/2012 | J (4) | 268933 | D | $50.715 (4) | 3617815 | I | Held through Buck Holdings, L.P. and Buck Holdings Co-Invest, L.P. (2) (7) (8) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/10/2012 | S | 46156 | D | $50.715 (1) | 607906 | I | Held through Buck Holdings, L.P. and KKR Partners III, L.P. (2) (9) (10) (11) | ||
Common Stock, par value $0.875 per share | 10/11/2012 | J (4) | 42062 | D | $50.715 (4) | 565844 | I | Held through Buck Holdings, L.P. and KKR Partners III, L.P. (2) (9) (10) (11) |
Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) |
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1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Remarks:
(12) Mr. Kreider is signing in his capacity as attorney-in-fact for William J. Janetschek, a director of KKR Fund Holdings GP Limited. (13) Mr. Kreider is signing in his capacity as attorney-in-fact for Mr. Janetschek, a director of KKR Group Limited, the general partner of KKR Group Holdings L.P. (14) Mr. Kreider is signing in his capacity as attorney-in-fact for Mr. Janetschek, a director of KKR Group Limited. (15) Mr. Kreider is signing in his capacity as attorney-in-fact for Mr. Janetschek, Chief Financial Officer of KKR Management LLC, the general partner of KKR & Co. L.P. (16) Mr. Kreider is signing in his capacity as attorney-in-fact for Mr. Janetschek, Chief Financial Officer of KKR Management LLC. |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
KKR Fund Holdings GP Ltd
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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KKR Group Holdings L.P.
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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KKR Group Ltd
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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KKR & Co. L.P.
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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KKR Management LLC
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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KRAVIS HENRY R
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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ROBERTS GEORGE R
C/O KOHLBERG KRAVIS ROBERTS & CO. L.P. 9 WEST 57TH STREET, SUITE 4200 NEW YORK, NY 10019 |
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X |
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Signatures
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/s/ Richard J. Kreider, KKR Fund Holdings GP Limited (12) | 10/12/2012 | |
** Signature of Reporting Person |
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/s/ Richard J. Kreider, KKR Group Holdings L.P. (13) | 10/12/2012 | |
** Signature of Reporting Person |
Date
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/s/ Richard J. Kreider, KKR Group Limited (14) | 10/12/2012 | |
** Signature of Reporting Person |
Date
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/s/ Richard J. Kreider, KKR & Co. L.P. (15) | 10/12/2012 | |
** Signature of Reporting Person |
Date
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/s/ Richard J. Kreider, KKR Management LLC (16) | 10/12/2012 | |
** Signature of Reporting Person |
Date
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/s/ Richard J. Kreider, as Attorney-in-Fact for Henry R. Kravis | 10/12/2012 | |
** Signature of Reporting Person |
Date
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/s/ Richard J. Kreider, as Attorney-in-Fact for George R. Roberts | 10/12/2012 | |
** Signature of Reporting Person |
Date
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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 4(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. |
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