SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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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OMB Number: 3235-0362
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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).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
HANONO FANNY

(Last) (First) (Middle)
3000 N.W. 107TH AVENUE

(Street)
MIAMI FL 33172

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PERRY ELLIS INTERNATIONAL INC [ PERY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Secretary and Treasurer
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
01/31/2004
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock 07/14/2003 G 430 D $0 83,260 I See Footnote(1)
Common Stock 12/17/2003 G 550 D $0 82,710 I See Footnote 1
Common Stock 12/17/2003 G 350 D $0 82,360 I See Footnote 1
Common Stock 12/17/2003 G 150 D $0 82,210 I See Footnote 1
Common Stock 12/18/2003 G 5,000 D $0 309,958 I See Footnote(2)
Common Stock 12/18/2003 J 5,000 A $0 87,210 I See Footnotes 1 and(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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options $8 12/02/1995 12/01/2005 Common Stock 9,250 9,250 I See Footnote(4)
Stock Options $14.25 12/05/2002 12/04/2012 Common Stock 10,000 10,000 I See Footnote 4
Stock Options $5.188 01/04/2001 01/03/2011 Common Stock 10,000 10,000 I See Footnote 4
Stock Options $8.81 04/23/1999 04/22/2009 Common Stock 10,000 10,000 I See Footnote 4
Explanation of Responses:
1. Owned by the Feldenkreis Family Foundation, Inc. of which the Reporting Person is an officer and director.
2. Owned by a limited partnership of which the Reporting Person is sole shareholder of the sole general partner and the sole limited partner.
3. Represents a gift made by a limited partnership of which the Reporting Person is sole shareholder of the sole general partner and the sole limited partner to the Feldenkreis Family Foundation, Inc., of which the Reporting Person is an officer and director.
4. Owned by the Reporting Person's spouse.
Fanny Hanono 03/16/2004
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.