SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MATTHIAS DAN W

(Last) (First) (Middle)
C/O MOTHERS WORK, INC.
456 NORTH 5TH STREET

(Street)
PHILADELPHIA PA 19123

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MOTHERS WORK INC [ MWRK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
CEO
3. Date of Earliest Transaction (Month/Day/Year)
11/12/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/12/2004 M 13,635(1) A $11.25(2) 486,226 I See footnote(1)(3)
Common Stock 11/12/2004 F 9,522(2) D $16.11 476,704 D(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option (Right to Buy) $11.25(2) 11/12/2004 M 13,635 11/16/1994 11/16/2004 Common Stock 13,635 $0 0 I See footnote(1)
Explanation of Responses:
1. On 11/12/04, Rebecca C. Matthias, the Reporting Person's wife, exercised options to purchase 13,635 shares of Common Stock of the Issuer which were set to expire on November 16, 2004. The Reporting Person is deemed to beneficially own the shares of Common Stock of the Issuer obtained through the option exercise by his spouse.
2. As payment for the exercise price for such options held by Rebecca C. Matthias, each of the Reporting Person and Rebecca C. Matthias jointly transferred to the Issuer 9,522 shares of Common Stock of the Issuer. The transfer of shares of Common Stock of the Issuer was approved by a majority of the disinterested directors of the Company and, therefore, is an exempt transaction under Section 16(b) pursuant to Rule 16b-3(e).
3. The shares of Common Stock of the Issuer, after giving effect to the reported transactions, are held jointly by the Reporting Person and his wife, Rebecca C. Matthias.
Dan Matthias 11/15/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
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