-----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, SnOMCSNL9BUyGOEpE3rViSG1IrUWkHqDDkzoP6XsVTzIfoaIyF8PDHR3QYbMHtbf M25A6vyC8VMrzEkwoyYguA== 0000901845-04-000004.txt : 20040510 0000901845-04-000004.hdr.sgml : 20040510 20040510145843 ACCESSION NUMBER: 0000901845-04-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040507 FILED AS OF DATE: 20040510 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: 04792590 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 2004-05-07 0 0000718916 BURLINGTON COAT FACTORY WAREHOUSE CORP BCF 0000901845 MILSTEIN ANDREW R 1830 RT. 130 BURLINGTON NJ 08016 1 1 1 0 Executive Vice President Common Stock, $1.00 Par Value 2004-05-07 4 G 0 3928 0 A 131211 I See footnote Common Stock, $1.00 Par Value 2781395 D This includes 37,306 shares held by the Andrew Milstein Trust and 8,302 held by the AHM Trust and 9,675 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/ Andrew Milstein 2004-05-07 -----END PRIVACY-ENHANCED MESSAGE-----