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 -------------------------------- OMB APPROVAL - ----------------------------------- -------------------------------- FORM 3 OMB Number: 3235-0104 - ----------------------------------- Expires: September 30, 1998 Estimated average burden hours per response .... 0.5 --------------------------------
1. Name and Address of Reporting Person * Platoni Poli Nancy A. (Last) (First) (Middle) 9 Polito Avenue (Street) Lyndhurst NJ 07071 (City) (State) (Zip) 2. Date of Event Requiring Statement ( Month / Day / Year ) 6/12/97 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol Polo Ralph Lauren Corporation (RL) 5. Relationship of Reporting Person to Issuer (Check all applicable) Director 10% Owner ----- ----- X Officer (give title Other ----- below) ----- (specify below) Vice President and Chief Financial Officer ------------------------------------------ 6. If Amendment, Date or Original (Month/Year) 7. Individual or Join/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 2. Amount of Securities 3. Ownership 4. Nature of Indirect (Inst.4) Beneficially Owned Form: Direct (D) Beneficial Ownership (Instr. 4) or Indirect (I) (Instr. 5) (Inst. 5) - ---------------------------------------------- ------------------------------ ------------------- ------------------------------- - ---------------------------------------------- ------------------------------ ------------------- ------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the Form is filed by more than one reporting person, SEE instruction 5(b)(v). SEC 1473(8-92)
FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) 1. Title of Derivative Security 2. Date Exercisable and 3. Title and Amount of Securities Underlying (Instr. 4) Expiration Date Derivative Security (Instr. 4) (Month/Day/Year) Amount or Date Expiration Title Number of Exercisable Date Shares - --------------------------------------------------- ----------- ----------- ---------------------- ----------------------------- Options issued pursuant to Issuer's 1997 Long-Term Stock Incentive Plan (Right to Buy) * 6/11/2007 Class A Common Stock 29,000 - --------------------------------------------------- ----------- ----------- ---------------------- ----------------------------- 4. Conversion or 5. Ownership 6. Nature of Indirect Exercise Price of Form of Beneficial Ownership Derivative Derivative (Instr. 5) Security Security: Direct (D) or Indirect (I) (Instr. 5) - ---------------------------- --------------------- ------------------------------------------------ $26.00 D - ---------------------------- --------------------- ------------------------------------------------
Explanation of Responses: *The option vests and becomes exercisable in three equal annual installments beginning on June 11, 1998. **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/ Nancy A. Platoni Poli June 11, 1997 - ----------------------------------------------- ---------------------- **Signature of Reporting Person Date Nancy A. Platoni Poli