SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 17)*
JACOBSON STORES INC.
(Name of Issuer)
Common Stock, $1 par value
(Title of Class of Securities)
469834 10 5
(CUSIP Number)
Check the following box if a fee is being paid with this statement [ ]. (A fee
is not required only if the filing person: (1) has a previous statement on
file reporting beneficial ownership of more than five percent of the class of
securities described in Item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7.)
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities,
and for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be
deemed to be "filed" for the purpose of Section 18 of the Securities Exchange
Act of 1934 ("Act") or otherwise subject to the liabilities of that section of
the Act but shall be subject to all other provisions of the Act (however, see
the Notes).
(Continued on following pages)
Page 1 of 5
<PAGE>
CUSIP No. 469834 10 5 13G
1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
DAVID A. ROSENFELD
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [ ]
(b) [X]
3 SEC USE ONLY
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
5 SOLE VOTING POWER
NUMBER OF
SHARES 325
BENEFICIALLY
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 1,095,536.3
PERSON
WITH 7 SOLE DISPOSITIVE POWER
325
8 SHARED DISPOSITIVE POWER
1,095,536.3
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,095,861.3
10 CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
18.9%
12 TYPE OF REPORTING PERSON
IN
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<PAGE>
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
Item 1(a). Name of Issuer:
Jacobson Stores Inc.
Item 1(b). Address of Issuer's Principal Executive Offices:
3333 Sargent Road
Jackson, Michigan 49201-8847
Item 2(a). Name of Person Filing:
David A. Rosenfeld
Item 2(b). Business Address:
875 Battery
San Francisco, California 94111
Item 2(c). Citizenship:
United States
Item 2(d). Title of Class of Securities:
Common Stock, $1 par value
Item 2(e). CUSIP Number:
469834 10 5
Item 3. If this statement is filed pursuant to Rules 13d-1(b) or
13d-2(b):
(Inapplicable)
Page 3 of 5
<PAGE>
Item 4. Ownership:
(a) Amount Beneficially Owned: 1,095,861.3 shares
(b) Percent of Class: 18.9%
(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote:
325
(ii) shared power to vote or to direct the vote:
1,095,536.3*
(iii) sole power to dispose or to direct the
disposition of:
325
(iv) shared power to dispose or to direct the
disposition of:
1,095,536.3*
*Includes 459 shares issuable on conversion of debentures
(treated as if converted and subject to a Voting Agreement) and
7,250 stock option shares (treated as if exercised and subject
to a Voting Agreement).
Pursuant to Rule 13d-4, the undersigned hereby declares that
the filing of this statement shall not be construed as an
admission that the undersigned is, for the purposes of Section
13(d) or 13(g) of the Securities Exchange Act of 1934, the
beneficial owner of the following securities covered by this
statement:
748,497 shares of a total of 1,095,536.3 shares subject to a
Voting and Transfer Restriction Agreement, effective
December 31, 1990, among Robert L., David A., and Mark K.
Rosenfeld, and the wife of each of them.
Item 5. Ownership of Five Percent or Less of a Class.
(Inapplicable)
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<PAGE>
Item 6. Ownership of More than Five Percent on Behalf of Another Person.
The following persons have the right to receive dividends
from, or the proceeds from the sale of, the following
securities referred to in this statement (refer to answer to
Item 4):
748,497 shares: Robert L. Rosenfeld, Mark K.
Rosenfeld, the wife of each of them, and the
issue of Mark K. Rosenfeld.
Item 7. Identification and Classification of the Subsidiary Which
Acquired the Security Being Reported on by the Parent Holding
Company.
(Inapplicable)
Item 8. Identification and Classification of Members of the Group.
(Inapplicable)
Item 9. Notice of Dissolution of Group.
(Inapplicable)
Item 10. Certification.
(Inapplicable)
Signature
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Dated: February 9, 1996.
/s/ David A. Rosenfeld
----------------------
David A. Rosenfeld
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