<TABLE>
<CAPTION>
FORM 4
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[ ] CHECK THIS BOX IF NO LONGER OMB APPROVAL
SUBJECT TO SECTION 16. FORM 4 OR --------------------------------
FORM 5 OBLIGATIONS MAY CONTINUE. OMB NUMBER: 3235-0287
SEE INSTRUCTION 1(b). EXPIRES: SEPTEMBER 30, 1998
ESTIMATED AVERAGE BURDEN
HOURS PER RESPONSE..........0.5
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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
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<S> <C> <C>
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting
Person to Issuer
Abada, Rami Jennifer Convertibles, Inc.(JENN) (Check all applicable)
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(Last) (First) (Middle) 3. IRS or Social 4. Statement for Month/Year [X] Director [ ] 10% Owner
c/o Jennifer Convertibles, Inc. Security Number [X]Officer [ ]Other
of Reporting 11/99 (give title (specify title
419 Crossways Park Drive Person below) below)
- --------------------------------------- (Voluntary) PRESIDENT, COO AND INTERIM ACTING CFO
(Street) ----------------------------
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Woodbury, NY 11797 5. If Amendment, 7. Individual or Joint/Group Filing
- --------------------------------------- Date of Original (Check Applicable Line)
(City) (State) (Zip) (Month/Year) [X] Form filed by One Reporting Person
N/A [ ] Form filed by More than One Reporting Person
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TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership Form: 7. Nature of
(Instr.3) action action Code or Disposed of (D) Securities Direct (D) or Indirect
Date (Instr. 8) (Instr. 3,4 and 5) Beneficially Indirect (I) Beneficial
Owned at End of (Instr. 4) Ownership
(Month/ Month (Instr. 4)
Day/Year)
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Code V Amount (A) or (D) Price (Instr. 3 and 4)
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COMMON STOCK 53,000 D
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
(Print or type Responses) SEC 1473 (7-96)
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<PAGE>
FORM 4 (continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(E.G., puts, calls, warrants, options, convertible securities)
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1. Title of 2. Conversion 3. Transaction 4. Transaction 5. Number of
Derivative or Exercise Date Code Derivative
Security Price of (Month/Day/Year) (Instr. 8) Securities
(Instr. 3) Derivative Acquired (A)
Security or Disposed
of (D)
(Instr. 3,4,
and 5)
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Code V (A) (D)
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Non-Qualified $3.51 11/30/99 A V 274,000
Stock Options
(right to buy)
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Incentive $3.51 11/30/99 A V 26,000
Stock Options
(right to buy)
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<TABLE>
<CAPTION>
FORM 4 (continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(E.G., puts, calls, warrants, options, convertible securities)
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<S> <C> <C> <C> <C> <C>
6. Date 7. Title and Amount 8. Price of 9. Number of 10. Ownership 11. Nature of
Exercisable of Underlying Derivative Derivative Form of Indirect
and Expiration Securities Security Securities Derivative Beneficial
Date (Instr. 3 and 4) Beneficially Security: Ownership
(Month/Day/Year) Owned at Direct (D) or (Instr. 4)
End of Indirect (I)
Month (Instr. 4)
(Instr. 4)
------------------------------------------
Amount
Date Expir- or
Exer- ation Number
cisable Date Title of Shares
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Non-Qualified (1) 11/29/2009 Common 274,000 274,000 D
Stock Options Stock
(right to buy)
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Incentive (1) 11/29/2009 Common 26,000 26,000 D
Stock Options Stock
(right to buy)
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(previously 200,000 D
reported options)
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</TABLE>
Explanation of Responses:
(1) Stock options subject to a three-year vesting period in which 1/3 of total
awarded shares shall vest each consecutive year for three years beginning on
8/15/2000.
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<S> <C> <C>
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ ABADA RAMI December 8, 1999
Note: File three copies of this Form, one of which must be manually signed. ------------------------------- ---------------
If space is insufficient, SEE Instruction 6 for procedure. **Signature of Reporting Person Date
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