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U.S. 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, Section 17(a) of the Public Utility
Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
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FORM 5 OMB APPROVAL
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[ ] CHECK THIS BOX IF NO LONGER OMB Number: 3235-0362
SUBJECT TO SECTION 16. FORM 4 Expires: September 30, 1998
OR FORM 5 OBLIGATIONS MAY Estimated average burden
CONTINUE. SEE INSTRUCTION 1(B). hours per response .... 1.0
[ ] FORM 3 HOLDINGS REPORTED
[ ] FORM 4 TRANSACTIONS REPORTED
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1. Name and Address of Reporting Person *
Matthews Norman S.
(Last) (First) (Middle)
11 Lincoln Lane
(Street)
Purchase New York 10577
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Loehmann's, Inc. (LOEH)
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement of Month/Year
January 1998
5. If Amendment, Date or Original (Month/Year)
6. Relationship of Reporting Person to Issuer (Check all applicable)
X Director 10% Owner
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Officer (give title Other
----- below) ----- (specify
below)
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7. Individual or Join/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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Form filed by More than One Reporting Person
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TABLE I-- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
1. Title of Security 2. Transaction 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) Date action or Disposed of (D) Securities ship of In-
Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Month/ (Instr. 8) Owned at Direct Bene-
Day/ ------------- ------------------------- End of (D) ficial
Year) (A) Month Indirect Owner-
Code Amount or Price (Instr. 3 (I) ship
(D) and 4) (Instr. 4) (Instr. 4)
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Common Stock, par value
$0.01 per share 17,839 D --
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(Over)
* If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 9-96)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer-
Security (Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex-
Exercise Date (Instr. 8) quired (A) or Dis- piration Date
Price of posed of (D)
Deriv- (Month/ (Instr. 3, 4 and 5) (Month/Day/
ative Day/ Year)
Secur Year) ------------- ------------------------- ----------------------
Code (A) (D) Date Expira-
Exer- tion
cisable Date
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Stock Options (1) -- -- -- -- (1) (1)
Class B Common Stock, par value $0.01
per share (2) -- -- -- 11/6/96 N/A
Stock Options 7.0625 6/19/97 A 65,000 (3) (3)
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7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na-
Underlying Securities Deriv of Deriv- ship ture
ative ative Form of In-
(Instr. 3 and 4) Secur- Secur- of De- direct
ity ities rivative Bene-
(Instr. Bene Secu- ficial
5) ficially rity: Own-
Owned Direct ership
- -------------------------------------- at End (D) or (Instr. 4)
Amount or of Indi-
Title Number of Month rect (I)
Shares (Instr. 4) (Instr. 4)
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Common Stock, par
value $0.01 per share 89,378 (1) 89,378 D
Common Stock, par
value $0.01 per share 22,345 (2) 22,345 D
Common Stock, par
value $0.01 per share 65,000 (3) 65,000 D
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Explanation of Responses:
(1) All options were granted pursuant to the 1988 Stock Option Plan and are
immediately exercisable. All options expire five years after the dates of
vesting. 44,688 options are exercisable at $5.01 a share, 22,345 options
are exercisable at $4.48 a share, and 22,345 options are exercisable at
$8.95 a share.
(2) One share of Class B Common Stock is convertible into one share of Common
Stock.
(3) All options were granted pursuant to the Directors Stock Option Plan. The
options shall vest in full on the earlier of (i) June 19, 2001 or (ii) a
Change of Control of the Company, and expire at the earlier of (i) 10 years
from the grant date and (ii) one year from the date the Optionee's service
terminates (capitalized terms in this sentence are as defined in the
Directors Stock Option Plan).
**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 provided is insufficient, SEE Instruction 6 for procedure.
/s/ Norman S. Matthews February 23, 1998
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**Signature of Reporting Person Date
Norman S. Matthews
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB number.
Page 2
SEC 2270 (9-96)
