-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, EjqYhMA0DKSMH9HelHeMR19P/03GcK5mXeN+aN6H3FPG4q6BJxg7UpA0HI3XnA8v 0W+jpfa2RGblZ2SH9liFXA== 0000950137-97-000713.txt : 19970222 0000950137-97-000713.hdr.sgml : 19970222 ACCESSION NUMBER: 0000950137-97-000713 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970218 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL AUTOMOTIVE INDUSTRIES INC /DE/ CENTRAL INDEX KEY: 0000931457 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MOTOR VEHICLE SUPPLIES & NEW PARTS [5013] IRS NUMBER: 363973627 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-50307 FILM NUMBER: 97536911 BUSINESS ADDRESS: STREET 1: 3350 NORTH KEDZIE CITY: CHICAGO STATE: IL ZIP: 60618 BUSINESS PHONE: 3124782323 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ISRAEL SAMI CENTRAL INDEX KEY: 0001033703 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 3350 NORTH KEDZIE CITY: CHICAGO STATE: IL ZIP: 60618 BUSINESS PHONE: 7734782323 MAIL ADDRESS: STREET 1: 3350 NORTH KEDZIE CITY: CHICAGO STATE: IL ZIP: 60618 SC 13G 1 SCHEDULE 13G 1 SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Amendment No. 1 Under the Securities Exchange Act of 1934 UNIVERSAL AUTOMOTIVE INDUSTRIES, INC. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 913 378 10 5 - -------------------------------------------------------------------------------- (CUSIP Number) Check the following box if a fee is being paid with this statement [ ]. (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) Page 1 of 4 pages 2 Page 2 of 4 pages
CUSIP No.: 913 378 105 - --------------------------------------------------------------------------------------------- 1) Names of Reporting Persons S.S. or I.R.S. Identification Nos. of Above Persons Sami Israel - --------------------------------------------------------------------------------------------- 2) Check the Appropriate Box if a Member of a Group (a) Not Applicable (b) [ ] - --------------------------------------------------------------------------------------------- 3) SEC Use Only - --------------------------------------------------------------------------------------------- 4) Citizenship or Place of Organization United States - --------------------------------------------------------------------------------------------- Number of 5) Sole Voting Power Shares ------------------------------------------------------------------- Beneficially 6) Shared Voting Power 905,000 Owned ------------------------------------------------------------------- by Each 7) Sole Dispositive Power Reporting ------------------------------------------------------------------- Person With 8) Shared Dispositive Power 905,000 - --------------------------------------------------------------------------------------------- 9) Aggregate Amount Beneficially Owned by Each Reporting Person 905,000 - --------------------------------------------------------------------------------------------- 10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares - --------------------------------------------------------------------------------------------- 11) Percent of Class Represented by Amount in Row (9) 13.45% - --------------------------------------------------------------------------------------------- 12) Type of Reporting Person IN - ---------------------------------------------------------------------------------------------
3 Page 3 of 4 pages ITEM 1(a) NAME OF ISSUER: Universal Automotive Industries, Inc. ITEM 1(b) NAME OF PERSON FILING: Sami Israel Item 2(b) Address of Principal Business Office or, if none, Residence: 3350 North Kedzie, Chicago, Illinois 60618-5722 Item 2(c) Citizenship: United States Item 2(d) Title of Class of Securities: Common Stock Item 2(e) CUSIP Number: 913 378 10 5 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13d-1(b), OR 13d-2(b), CHECK WHETHER THE PERSON FILING IS A: (a) [ ] Broker or Dealer registered under Section 15 of the Act (b) [ ] Bank as defined in section 3(a)(6) of the Act (c) [ ] Insurance Company as defined in section 3(a)(19) of the Act (d) [ ] Investment Company registered under section 8 of the Investment Company Act (e) [ ] Investment Adviser registered under section 203 of the Investment Advisers Act of 1940 (f) [ ] Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; see Section 240.13d-1(b)(1)(ii)(F) (g) [ ] Parent Holding Company, in accordance with Section 240.13d-1(b)(ii)(G) (Note: See Item 7) (h) [ ] Group, in accordance with Section 240.13d-1(b)(1)(ii)(H) ITEM 4. OWNERSHIP (a) Amount Beneficially Owned: 905,000 shares of Common Stock 4 Page 4 of 4 pages (b) Percent of Class: 13.45% (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote (ii) shared power to vote or to direct the vote 905,000 (iii) sole power to dispose or to direct the disposition of (iv) shared power to dispose or to direct the disposition of 905,000 ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [ ]. ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON Not Applicable ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY Not Applicable ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP Not Applicable. ITEM 9. NOTICE OF DISSOLUTION OF GROUP Not Applicable ITEM 10. CERTIFICATION Signature. After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date: February 14, 1997 Signature: /s/ Sami Israel - ----------------- Sami Israel -----END PRIVACY-ENHANCED MESSAGE-----