SEC FORM
3/A
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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 APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/17/2005
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3. Issuer Name and Ticker or Trading Symbol
Citi Trends Inc
[ CTRN ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
X |
Other (specify below) |
See Exhibit 99.1 |
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5. If Amendment, Date of Original Filed
(Month/Day/Year) 05/17/2005
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Common Stock, par value $.01 per share |
7,546,404
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D
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Common Stock, par value $.01 per share |
1,255,486 |
D
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Common Stock, par value $.01 per share |
25,109 |
D
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Stock Options (1999 Stock Option Plan) |
08/02/2003 |
08/02/2013 |
Common Stock, par value $.01 per share |
37,050
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3.6154 |
D
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Stock Options (1999 Stock Option Plan) |
10/30/2004 |
10/30/2014 |
Common Stock, par value $.01 per share |
29,562
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6.8462 |
D
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
Remarks: |
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HAMPSHIRE EQUITY PARTNERS II, L.P.
By: Lexington Equity Partners II, L.P., its General Partner
By: Lexington Equity Partners II, Inc., its General Partner
By:/s/ Gregory P. Flynn
Name: Gregory P. Flynn
Title: Vice President |
04/03/2007 |
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HAMPSHIRE EQUITY PARTNERS CAYMAN D.B. II, L.P.
By: Lexington Equity Partners Cayman II, L.P., its General Partner
By: Lexington Equity Partners II, Inc., its General Partner
By:/s/ Gregory P. Flynn
Name: Gregory P. Flynn
Title: Vice President |
04/03/2007 |
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HAMPSHIRE EQUITY PARTNERS CAYMAN II, L.P.
By: Lexington Equity Partners Cayman II, L.P., its General Partner
By: Lexington Equity Partners II, Inc., its General Partner
By:/s/ Gregory P. Flynn
Name: Gregory P. Flynn
Title: Vice President |
04/03/2007 |
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LEXINGTON EQUITY PARTNERS II, L.P.
By: Lexington Equity Partners II, Inc., its General Partner
By:/s/ Gregory P. Flynn
Name: Gregory P. Flynn
Title: Vice President |
04/03/2007 |
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LEXINGTON EQUITY PARTNERS CAYMAN II, L.P.
By: Lexington Equity Partners II, Inc., its General Partner
By:/s/ Gregory P. Flynn
Name: Gregory P. Flynn
Title: Vice President |
04/03/2007 |
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LEXINGTON EQUITY PARTNERS II, INC.
By:/s/ Gregory P. Flynn
Name: Gregory P. Flynn
Title: Vice President |
04/03/2007 |
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** 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
5
(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. |
Exhibit 99.1
Hampshire Equity Partners II, L.P. ("HEP II") is a 10% holder of record of
common stock of Citi Trends, Inc. ("Citi Trends"). Hampshire Equity Partners
Cayman D.B. II, L.P. ("HEP D.B. II") and Hampshire Equity Partners Cayman II,
L.P. ("HEP Cayman II" and together with HEP II and HEP D.B. II, the "Hampshire
Funds") are also record holders of common stock of Citi Trends, Inc. and are
controlled by the entity that also controls HEP II. See footnotes 2, 3 and 4
regarding beneficial ownership of shares held by the Hampshire Funds.