SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES 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
or Section 30(h) of the Investment Company Act of 1940
 
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1. Name and Address of Reporting Person*
CORNELY JOSEPH H III

(Last) (First) (Middle)
555 TURNPIKE STREET
C/O CASUALMALE RETAIL GROUP

(Street)
CANTON MA 02021

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/02/2003
3. Issuer Name and Ticker or Trading Symbol
CASUAL MALE RETAIL GROUP INC [ CMRG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP,Director of Store Develop.
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock, $.01 par value 06/21/2003(1) 06/21/2012 Common Stock 25,000 7 D
Common Stock, $.01 par value 08/22/2003(2) 08/22/2012 Common Stock 7,000 4.6 D
Common Stock, $.01 par value 03/03/2004(3) 03/03/2013 Common Stock 50,000 2.73 D
Explanation of Responses:
1. Options granted June 21, 2002. 8,334 shares are currently exercisable and 8,333 shares will become exercisable on each of June 21, 2004 and June 21, 2005.
2. Options granted August 22, 2002. 2,334 shares are currently exercisable and 2,333 shares will become exercisable on each of August 22, 2004 and August 22, 2005.
3. Options granted March 2, 2003. 16,667 shares will become exercisable on each of March 3, 2004, March 3, 2005 and March 3, 2006.
Arlene C. Feldman Attorney-in-Fact for Joseph H. Cornely, III 12/15/2003
** Signature of Reporting Person Date
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).
** 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 is insufficient, see Instruction 6 for procedure.
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