SEC FORM 4 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*
DABAH EZRA

(Last) (First) (Middle)
915 SECAUCUS ROAD

(Street)
SECAUCUS NJ 07094

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CHILDRENS PLACE RETAIL STORES INC [ PLCE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
11/25/2003
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, Par Value $.10 11/21/2003 G V 25,000 D $28 6,047,070(1)(2) I Spouse
Common Stock, Par Value $.10 11/25/2003 S 1,612 D $29 6,045,458(3) I Trustee for daughter
Common Stock, Par Value $.10 11/26/2003 S 3,388 D $28.02 6,042,070(4) I Trustee for daughter
Common Stock, Par Value $.10 11/26/2003 S 5,000 D $28 6,037,070(5) I Trustee for son
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
Explanation of Responses:
1. Includes (i) 3,402,960 shares held by trusts or custodial accounts for the benefit of Mrs. Dabah's children and certain other family members, of which Mrs. Dabah or her husband is a trustee or custodian and as to which Mrs. Dabah or her husband, as the case may be, has voting control, and as to which shares Mrs. Dabah disclaims beneficial ownership; (ii) 2,506,850 held in Mrs. Dabah's husband's name; (iii) 37,600 shares held by Mrs. Dabah; and (iv) 99,660 shares subject to options held by Mrs. Dabah's husband which are currently exercisable. Does not include (i) 496,000 shares directly owned by Stanley Silverstein, Mrs. Dabah's father; (ii) 7,000 shares held in Mr. Silverstein's profit sharing account; and (iii) 121,000 shares directly owned by Raine Silverstein, Mrs. Dabah's mother.
2. The reporting person no longer has a reportable beneficial interest in 22,000 shares which were previously included in the reporting person's prior ownership reports.
3. Includes (i) 3,401,348 shares held by trusts or custodial accounts for the benefit of Mrs. Dabah's children and certain other family members, of which Mrs. Dabah or her husband is a trustee or custodian and as to which Mrs. Dabah or her husband, as the case may be, has voting control, and as to which shares Mrs. Dabah disclaims beneficial ownership; (ii) 2,506,850 held in Mrs. Dabah's husband's name; (iii) 37,600 shares held by Mrs. Dabah; and (iv) 99,660 shares subject to options held by Mrs. Dabah's husband which are currently exercisable. Does not include (i) 496,000 shares directly owned by Stanley Silverstein, Mrs. Dabah's father; (ii) 7,000 shares held in Mr. Silverstein's profit sharing account; and (iii) 121,000 shares directly owned by Raine Silverstein, Mrs. Dabah's mother.
4. Includes (i) 3,397,960 shares held by trusts or custodial accounts for the benefit of Mrs. Dabah's children and certain other family members, of which Mrs. Dabah or her husband is a trustee or custodian and as to which Mrs. Dabah or her husband, as the case may be, has voting control, and as to which shares Mrs. Dabah disclaims beneficial ownership; (ii) 2,506,850 held in Mrs. Dabah's husband's name; (iii) 37,600 shares held by Mrs. Dabah; and (iv) 99,660 shares subject to options held by Mrs. Dabah's husband which are currently exercisable. Does not include (i) 496,000 shares directly owned by Stanley Silverstein, Mrs. Dabah's father; (ii) 7,000 shares held in Mr. Silverstein's profit sharing account; and (iii) 121,000 shares directly owned by Raine Silverstein, Mrs. Dabah's mother.
5. Includes (i) 3,392,960 shares held by trusts or custodial accounts for the benefit of Mrs. Dabah's children and certain other family members, of which Mrs. Dabah or her husband is a trustee or custodian and as to which Mrs. Dabah or her husband, as the case may be, has voting control, and as to which shares Mrs. Dabah disclaims beneficial ownership; (ii) 2,506,850 held in Mrs. Dabah's husband's name; (iii) 37,600 shares held by Mrs. Dabah; and (iv) 99,660 shares subject to options held by Mrs. Dabah's husband which are currently exercisable. Does not include (i) 496,000 shares directly owned by Stanley Silverstein, Mrs. Dabah's father; (ii) 7,000 shares held in Mr. Silverstein's profit sharing account; and (iii) 121,000 shares directly owned by Raine Silverstein, Mrs. Dabah's mother.
Remarks:
Renee Dabah 12/01/2003
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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