UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MH FAMILY LLC C/O BURLINGTON COAT FACTORY 1830 ROUTE 130 BURLINGTON, NJ 08016 |
 |  X |  |  |
MHLAS LIMITED PARTNERSHIP NUMBER ONE C/O BURLINGTON COAT FACTORY 1830 ROUTE 130 BURLINGTON, NJ 08016 |
 |  X |  |  |
MILSTEIN HENRIETTA 2000 REVOCABLE TRUST C/O BURLINGTON COAT FACTORY 1830 ROUTE 130 BURLINGTON, NJ 08016 |
 |  X |  |  |
MM 2005 Intangibles Trust C/O BURLINGTON COAT FACTORY 1830 ROUTE 130 BURLINGTON, NJ 08016 |
 |  X |  |  |
/s/ Paul C. Tang, Trustee of Henrietta Milstein 2000 Revocable Trust, Member of MH Family LLC | 01/25/2006 | |
**Signature of Reporting Person | Date | |
/s/ Paul C. Tang, Trustee of Henrietta Milstein 2000 Revocable Trust, Member of MH Family LLC, General Partner of MHLAS Limited Partnership Number One | 01/25/2006 | |
**Signature of Reporting Person | Date | |
/s/ Paul C. Tang, Trustee of Henrietta Milstein 2000 Revocable Trust | 01/25/2006 | |
**Signature of Reporting Person | Date | |
/s/ Stephen E. Milstein, Trustee of MM 2005 Intangibles Trust | 01/25/2006 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | These securities are owned by MH Family LLC, which may be deemed to be a member of a "group" with Samgray, L.P., the Trust Established under Article Sixth of the Last Will and Testament of Henrietta Milstein (the "Article Sixth Trust"), Latzim Family LLC, Monroe G. Milstein, Andrew R. Milstein, Stephen E. Milstein, Lazer Milstein, the Henrietta Milstein 2000 Revocable Trust, the MM 2005 Intangibles Trust and MHLAS Limited Partnership Number One for purposes of Section 13(d) of the Exchange Act. |
(2) | These securities are owned by MHLAS Limited Partnership Number One, which may be deemed to be a member of a "group" with Samgray, L.P., the Article Sixth Trust, Latzim Family LLC, Monroe G. Milstein, Andrew R. Milstein, Stephen E. Milstein, Lazer Milstein, the Henrietta Milstein 2000 Revocable Trust, the MM 2005 Intangibles Trust and MH Family LLC for purposes of Section 13(d) of the Exchange Act. |
(3) | The Henrietta Milstein 2000 Revocable Trust (the "Trust") is the controlling Member of MH Family LLC ("MHLLC"), which is the general partner of MHLAS Limited Partnership Number One (the "Partnership"). Paul C. Tang, the General Counsel of the Issuer, is the trustee of the Trust and in such capacity has voting and dispositive power over the shares owned by MHLLC and the Partnership, but disclaims any pecuniary interest in such shares. |
(4) | These securities are owned by the MM 2005 Intangibles Trust, which may be deemed to be a member of a "group" with Samgray, L.P., the Article Sixth Trust, Latzim Family LLC, Monroe G. Milstein, Andrew R. Milstein, Stephen E. Milstein, Lazer Milstein, the Henrietta Milstein 2000 Revocable Trust, MHLAS Limited Partnership Number One and MH Family LLC for purposes of Section 13(d) of the Exchange Act. Stephen E. Milstein, a director and officer of the Issuer, is the trustee of the MM 2005 Intangibles Trust and in such capacity has voting and dispositive power over the shares of Common Stock owned by such trust, but disclaims any pecuniary interest in such shares. |