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ROST » Topics » (Contact Plan Administrator for amount of tax due.)

This excerpt taken from the ROST 8-K filed May 23, 2008.
(Contact Plan Administrator for amount of tax due.)

           ™  Cash:  $     
™  Check:  $     

     5. Participant Information.

           My address is:   
     
           My Social Security Number is:   

     6. Binding Effect. I agree that the Shares are being acquired in accordance with and subject to the terms, provisions and conditions of the Grant Notice, the Option Agreement and the Plan, to all of which I hereby expressly assent. This Agreement shall inure to the benefit of and be binding upon my heirs, executors, administrators, successors and assigns.

Very truly yours, 
 
 
(Signature) 

Receipt of the above is hereby acknowledged.

ROSS STORES, INC.

By:     
Title:     
Dated:     

2

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