0001567619-19-002250.txt : 20190204
0001567619-19-002250.hdr.sgml : 20190204
20190204162558
ACCESSION NUMBER: 0001567619-19-002250
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190201
FILED AS OF DATE: 20190204
DATE AS OF CHANGE: 20190204
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shea Steven L
CENTRAL INDEX KEY: 0001472916
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-14120
FILM NUMBER: 19564020
MAIL ADDRESS:
STREET 1: C/O BLONDER TONGUE LABORATORIES, INC.
STREET 2: ONE JAKE BROWN ROAD
CITY: OLD BRIDGE
STATE: NJ
ZIP: 08857
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BLONDER TONGUE LABORATORIES INC
CENTRAL INDEX KEY: 0001000683
STANDARD INDUSTRIAL CLASSIFICATION: RADIO & TV BROADCASTING & COMMUNICATIONS EQUIPMENT [3663]
IRS NUMBER: 521611421
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: ONE JAKE BROWN RD
STREET 2: PO BOX 1000
CITY: OLD BRIDGE
STATE: NJ
ZIP: 08857
BUSINESS PHONE: 9086794000
MAIL ADDRESS:
STREET 1: ONE JAKE BROWN ROAD
CITY: OLD BRIDGE
STATE: NJ
ZIP: 08857
4
1
doc1.xml
FORM 4
X0306
4
2019-02-01
0
0001000683
BLONDER TONGUE LABORATORIES INC
BDR
0001472916
Shea Steven L
C/O BLONDER TONGUE LABORATORIES, INC.
ONE JAKE BROWN ROAD
OLD BRIDGE
NJ
08857
1
0
0
0
Common Stock, par value $0.001
2019-02-01
4
A
0
259983
0.54
A
632109
D
Common Stock, par value $0.001
15000
I
By Spouse
Shares were issued upon the conversion of $140,390.57 (principal and accrued interest) of outstanding convertible subordinated indebtedness of Blonder Tongue Laboratories, Inc. held by the reporting person.
Represents the conversion price of the convertible subordinated indebtedness.
/s/ Steven L. Shea by Eric Skolnik Under Power of Attorney
2019-02-04