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FORM 3 -------------------------------
OMB APPROVAL
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OMB number: 3235-0104
Expires: April 30, 1997
Estimated average burden
hours per response..........0.5
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U.S. 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, Section 17(a) of the Public Utility
Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
<S> <C> <C>
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| |
1. Name and Address of Reporting Person | 2. Date of Event Re- | 4. Issuer Name and Ticker or Trading Symbol
| quiring Statement |
Fourcar, B.V., a Netherlands corporation | (Month/Day/Year) | PetsMart, Inc. (NASDAQ: PETM)
- ----------------------------------------------| |---------------------------------------------------------
(Last) (First) (Middle) | | |
| 11/9/98 | 5. Relationship of Reporting | 6. If Amendment, Date
Coolsingel #139 3012 AG Rotterdam | | Person to Issuer | of Original
- ----------------------------------------------|--------------------------| (Check all applicable) | (Month/Day/Year)
(Street) | 3. IRS or Social Se- | |-----------------------
| curity Number of | __ Director X 10% Owner| 7. Individual or Joint/
| Reporting Person | __ Officer __ Other | Group Filing
| (Voluntary) | (give title (specify | X Form filed by One
| | below) below) | Reporting Person
| | _________________ | __ Form filed by More
The Netherlands | | |than OneReporting Person
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(City) (State) (Zip) | Table I -- Non-Derivative Securities Beneficially Owned
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1. Title of Security | 2. Amount of Securities | 3. Ownership | 4. Nature of Indirect
(Instr. 4) | Beneficially Owned | Form: Direct | Beneficial Ownership
| (Instr. 4) | (D) or Indirect | (Instr. 5)
| | (I) (Instr. 5) |
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Common Stock, par value $.0001 per share | 9,663,018 | D |
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Common Stock, par value $.0001 per share | 3,519,566 | I(1) | (1)
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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).
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 control number.
(Over)
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FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g.,
puts, calls, warrants, options, convertible securities)
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1. Title of Derivative | 2. Date Exercisable | 3. Title and Amount of | 4. Conver- | 5. Owner- | 6. Nature of
Security | and Expiration | Securities Underlying | sion or | ship | Indirect
(Instr. 4) | Date | Derivative Security | Exercise | Form of | Beneficial
| (Month/Day/Year) | (Instr. 4) | Price of | Deriv- | Ownership
| | | Deri- | ative | (Instr. 5)
| | | vative | Security: |
| | | Security | Direct |
|------------------------|------------------------------| | (D) or |
| Date | Expira- | Title | Amount or | | Indirect |
| Exer- | tion | | Number of | | (I) |
| cisable | Date | | Shares | | (Instr. 5)|
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Explanation of Responses:
(1) These shares may be deemed to be beneficially owned indirectly by Fourcar, B.V., and its direct parent, Carrefour S.A., as a
result of Carrefour S.A.'s merger with Societe de Noyange S.A, a French company.
** Intentional misstatements or omissions of facts constitute Federal FOURCAR, B.V.
Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
By:/s/ Yves Sisteron 2/17/99
Note: File three copies of this Form, one of which must be manually signed. ---------------------- Date
If space provided is insufficient, See Instruction 6 for procedure. ** Signature of Reporting
Person
Title: Authorized Signatory
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POWER OF ATTORNEY
General
This Power of Attorney is made as of this 12th day of February 1999 by Fourcar
B.V., a closed company with limited liability (the "Principal"), resident in
Amsterdam, The Netherlands in these presents represented by Mr. Jacques BADIN,
Managing Director of the Principal.
For the term commencing on the day hereof and remaining in effect until revoked
by an instrument in writing, the Principal (1) does hereby nominate, constitute
and appoint Yves Sisteron as the Principal's true and lawful attorney in fact,
to act in Principal's name and stead, and for the Principal's use and benefit
(2) does hereby grant to said attorney in fact full and complete authority to
execute and act on the Principal's behalf in connection with documents to be
filed with, and make declarations and statements for and to, U.S. governmental
and quasi-governmental agencies and regulatory authorities, including, without
limitation, the Internal Revenue Service, Securities and Exchange Commission,
Federal Trade Commission, and U.S. courts.
This Power of Attorney is granted upon the following conditions:
a. That the said attorney supplies to the Principal and original of any
documents signed pursuant to this Power of Attorney immediately upon
such signature;
b. That the attorney promptly informs the Principal of any oral engagement
undertaken by him with any person pursuant to this Power of Attorney;
c. That the attorney furnishes a full report to the Principal on a regular
basis of his activities pursuant to the exercise of these powers
granted by the Principal.
GIVING AND GRANTING to said attorney in fact full power and authority, but
without the power of substitution, to do and perform all and every act and thing
whatsoever requisite necessary or proper to be done relative to any of the
foregoing as fully as the Principal might or could do if personally present and
whereby ratifying and confirming all that said attorney in fact shall lawfully
do or cause to be done under the authority of this Power of Attorney.
This Power of Attorney shall be subject to French law and the Jurisdiction of
the Court of Appeal of Paris and its subsidiary courts.
IN WITNESS WHEREOF, this Power of Attorney is made and executed as of the date
first set forth above.
This power is given for one year beginning as of the date first set forth in the
above and may be renewed in writing.
FOURCAR B.V.
Name: J. B. Badin
Title: Managing Director