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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Option to Purchase Common Stock | $ 22.375 | 09/08/2003 | M | 3,000 | 03/24/1999 | 03/26/2005 | Common Stock | 3,000 | $ 22.375 | 0 (3) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BRODERICK DENNIS J C/O FEDERATED DEPARTMENT STORES, INC. 7 WEST SEVENTH STREET CINCINNATI, OH 45202 |
SVP, Secretary&General Counsel |
/s/ Padma Tatta Cariappa, as attorney-in-fact for Dennis J. Broderick pursuant to a Power of Attorney | 09/09/2003 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Since the date of the reporting person's last ownership report, he transferred 12,000 shares of the Issuer's common stock to his former spouse pursuant to a domestic relations order. |
(2) | Reflects matching contributuions under the Issuer's 401(k) plan, derived by dividing the value of the undivided interest of the reporting person in the applicable investment fund as of September 8, 2003 by $43.82, the stock price of such date. |
(3) | Since the date of the reporting person's last ownership report, he transferred the following employee stock options to purchase shares of the Issuer's common stock to his former spouse pursuant to a domestic relations order: 4,500 from grant dated March 24, 1995, 5,400 from grant dated March 22, 1996, 5,400 from grand dated March 28, 1997, 21,600 from grant dated March 27, 1998, 8,400 from grant dated February 25, 2000, 8,400 from grant dated March 23, 2001, 36,000 from grant dated June 8, 2001, 10,800 from grant dated March 22, 2002 and 13,800 from grant dated March 28, 2003. |