-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, EICrwebczl+ewHEYyqLhcSYE6UfCswgdcIT8AMhmk+JWlrfWobgt/pc3K61gVK00 KHc122JxZQZ1wmgHOyE47g== 0001179110-03-010789.txt : 20031114 0001179110-03-010789.hdr.sgml : 20031114 20031114165711 ACCESSION NUMBER: 0001179110-03-010789 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030930 FILED AS OF DATE: 20031114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GOLDBLUM JOSEPH CENTRAL INDEX KEY: 0001270005 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21196 FILM NUMBER: 031005620 BUSINESS ADDRESS: STREET 1: GOLDBLUM 7 HESS JENKINTOWN PLAZA STREET 2: 101 GREENWOOD AVE STE. 380 CITY: JENKINTOWN PLAZA STATE: PA ZIP: 19046 MAIL ADDRESS: STREET 1: 1788 PAPER MILL RD CITY: MEADOWBROOK STATE: PA ZIP: 19046 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MOTHERS WORK INC CENTRAL INDEX KEY: 0000896985 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-WOMEN'S CLOTHING STORES [5621] IRS NUMBER: 133045573 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 456 N 5TH ST CITY: PHILADELPHIA STATE: PA ZIP: 19123 BUSINESS PHONE: 2158732200 5 1 edgar.xml FORM 5 - X0201 5 2003-09-30 0 0 0 0000896985 MOTHERS WORK INC mwrk 0001270005 GOLDBLUM JOSEPH C/O GOLDBLUM & HESS JENKINTOWN PLAZA SUITE 380 JENKINTOWN PA 19046 1 0 0 0 Option (Right to Buy) 31.80 2003-02-07 5 A 0 L 3000 0 A 2003-02-07 2013-02-07 Common Stock 3000 3000 D Joseph Goldblum signed by Dan Matthias under power of attorney 2003-11-14 -----END PRIVACY-ENHANCED MESSAGE-----