-----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, Jycx2hGYmgVreYubNC07B7kUjiwLRdYCdcBRKHh/lghuxQj14MKl1IJ0QjBUqU4V 3AGztjGHHMh0FT6tCIaKuw== 0000901845-04-000007.txt : 20041102 0000901845-04-000007.hdr.sgml : 20041102 20041102151426 ACCESSION NUMBER: 0000901845-04-000007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041029 FILED AS OF DATE: 20041102 DATE AS OF CHANGE: 20041102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BURLINGTON COAT FACTORY WAREHOUSE CORP CENTRAL INDEX KEY: 0000718916 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DEPARTMENT STORES [5311] IRS NUMBER: 221970303 STATE OF INCORPORATION: DE FISCAL YEAR END: 0530 BUSINESS ADDRESS: STREET 1: 1830 RTE 130 CITY: BURLINGTON STATE: NJ ZIP: 08016 BUSINESS PHONE: 6093877800 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MILSTEIN ANDREW R CENTRAL INDEX KEY: 0000901845 STATE OF INCORPORATION: NJ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08739 FILM NUMBER: 041113139 BUSINESS ADDRESS: STREET 1: C/O BURLINGTON COAT FACTORY WAREHOUSE CO STREET 2: 1830 ROUTE 130 CITY: BURLINGTON STATE: NJ ZIP: 08016 BUSINESS PHONE: 6093877800 4 1 primary_doc.xml PRIMARY DOCUMENT X0202 4 2004-10-29 0 0000718916 BURLINGTON COAT FACTORY WAREHOUSE CORP BCF 0000901845 MILSTEIN ANDREW R 1830 RT. 130 BURLINGTON NJ 08016 1 1 1 0 Executive V.P. Common Stock, $1.00 Par Value 2004-10-29 4 G 0 13600 0 D 2766651 D Common Stock, $1.00 Par Value 6743984 I by spouse Common Stock, $1.00 Par Value 145955 I see footnote Represents shares in which the reporting person's spouse may be deemed to have an indirect interest. Accordingly, the reporting person may also be deemed to have an indirect interest in such shares. The reporting person disclaims any such interest. Includes 40,706 shares held by the Andrew Milstein Trust and 12,846 shares held by the AHM Trust and 16,475 shares held by the DJM Trust, trusts established for the benefit of the children of Andrew Milstein. Such shares are reported by reason of Rule 16a-1(a)(2)(ii)(A), but Andrew Milstein disclaims any pecuniary interest in such shares. This also includes 75,928 shares owned by Samgray, L.P., a limited partnership. Andrew Milstein, as a member of Latzim Family, LLC (the general partner of Samgray, L.P.) and as a limited partner of Samgray, L.P., has a pecuniary interest in these shares. /s/ Brian Flynn by power of attorney previously filed 2004-11-02 -----END PRIVACY-ENHANCED MESSAGE-----