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OMB APPROVAL
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- -------- OMB Number: 3235-0104
FORM 3 Expires: April 30, 1997
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hours per response .... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 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
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<S> <C> <C> <C>
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1. Name and Address of Reporting Person 2. Date of Event Requiring 4. Issuer Name and Ticker or
Apollo Investment Fund, L.P. Statement Trading Symbol
- ---------------------------------------- (Month/Day/Year) DOMINICK'S SUPERMARKETS, INC. DFF
(Last) (First) (Middle) 10/28/96 ----------------------------------------------------------
c/o Apollo Advisors, L.P. ---------------------------- 5. Relationship of Reporting 6. If Amendment, Date
Two Manhattanville Road 3. IRS or Social Security Person to Issuer of Original
- ---------------------------------------- Number of Reporting (Check all applicable) (Month/Day/Year)
(Street) Person (Voluntary) Director x 10% Owner
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Purchase, New York 10577 ---------------------------- ----- Officer ----- Other (specify
- -------------------------------------- (give title below) below)
(City) (State) (Zip) ---------------------------
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TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
(Instr. 4) Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership (Instr. 5)
(Instr. 5)
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Common Stock (1) (3) 1,699,979 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 (8/92)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C>
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1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect
(Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership
Expiration Date Derivative Security Exercise Form of (Instr. 5)
(Month/Day/ (Instr. 4) Price of Deriv-
Year) Deri- ative
vative Security:
Security Direct
------------------------------------------------- (D) or
Date Expira- Amount or Indirect (I)
Exercis- tion Title Number (Instr. 5)
able Date of Shares
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Class B Common Stock (2)(3) Immed N/A Common Stock 1,227,612 1 for 1 D
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Explanation of Responses:
1. The Reporting Person's beneficial ownership excludes 1,699,979 shares of Common Stock of Dominick's Supermarkets, Inc. (the
"Issuer") owned by Apollo Investment Fund III, L.P. and certain of its affiliates ("AIF III"). The general partner of the Reporting
Person and the general partner of AIF III are affiliated entities.
2. The Reporting Person's beneficial ownership excludes 1,227,611 shares of Class B Common Stock of the Issuer owned by AIF III.
3. The Reporting Person disclaims beneficial ownership of all securities owned by AIF III, and this report shall not be deemed an
admission that the Reporting Person is the beneficial owner of such shares for purposes of Section 16 or for any other purpose.
APOLLO INVESTMENT FUND, L.P.
**Intentional misstatements or omissions of facts constitute Federal Criminal By: Apollo Advisers, L.P., its General Partner
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). By: Apollo Capital Management, Inc., its
General Partner
Note. File three copies of this Form, one of which must be manually signed. By: /s/ Michael D. Weiner/Vice President 10/28/96
If space provided is insufficient, See Instruction 6 for procedure. ------------------------------------ ---------
**Signatire of Reporting Person Date
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SEC 1473 (8/92)
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