-----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, So0/baJi48NPp3uxLFVr0G/K6S+70P6OLhzpLsIFUCHKcss6AIuMXBqo6Gaf5r+l oNe0oQQhF5Xhh6UxIHMLBw== 0001077357-01-500216.txt : 20020410 0001077357-01-500216.hdr.sgml : 20020410 ACCESSION NUMBER: 0001077357-01-500216 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011110 FILED AS OF DATE: 20011113 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SURGICAL SAFETY PRODUCTS INC CENTRAL INDEX KEY: 0001063530 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 650565144 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24921 FILM NUMBER: 1784436 BUSINESS ADDRESS: STREET 1: 2018 OAK TERRACE CITY: SARASOTA STATE: FL ZIP: 34231 BUSINESS PHONE: 9419277874 MAIL ADDRESS: STREET 1: 2018 OAK TERRACE CITY: SARASOTA STATE: FL ZIP: 34231 COMPANY DATA: COMPANY CONFORMED NAME: SURGICAL SAFETY PRODUCTS INC CENTRAL INDEX KEY: 0001063530 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] OFFICER IRS NUMBER: 650565144 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 2018 OAK TERRACE CITY: SARASOTA STATE: FL ZIP: 34231 BUSINESS PHONE: 9419277874 MAIL ADDRESS: STREET 1: 2018 OAK TERRACE CITY: SARASOTA STATE: FL ZIP: 34231 3 1 sspd-f3rpg_11102001.txt INITIAL STATEMENT FORM 3 OMB Approval OMB Number 3235-0104 Expires: February 1, 1994 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 ___ Check if no longer subject to Section 16, Form 4 or Form 5, Obligation may continue. See Instructions _X_ Form 3 Holdings Reported ___ Form 4 Transaction 1. Name and Address of Reporting Person: Gray, R. Paul 43389 Deepspring Court Ashburn, VA 20147 2. Date of Event Requiring Statement: 9/30/01 3. IRS or SSN of Reporting Person (Voluntary): 4. Issuer Name and Ticker or Trading Symbol: Surgical Safety Products, Inc. SSPD 5. Relation of Reporting Person to Issuer X Director _ 10% owner X Officer (Title): Secretary, Treasurer _ Other (Specify) 6. If Amendment, Date of Original: 7. X Filed by One Reporting Person. _ Filed by more than One Reporting Person.
TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED 1. Title of Security: Common Stock Common Stock 2. Amount of Securities Beneficially Owned: 953,516 953,516 3. Ownership Form; Direct (D) or Indirect (I): I I 4. Nature of Indirect Beneficial Ownership: RPG, LLC R. Paul Gray Family, LLC
*If the form is filed by more than one Reporting Person, see instruction 5(b)(v) Reminder: Report on a separate Line for each class of securities beneficially owned directly or indirectly. TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED 1. Title of Derivative Security: N/A 2. Date Exercisable and Expiration Date: 3. Title and Amount of Underlying Securities: 4. Conversion or Exercise Price of Derivative Securities: 5. Ownership of Derivative Securities; Direct (D) or Indirect (I): 6. Nature of Indirect Beneficial Ownership: EXPLANATION OF RESPONSES: /s/ R. Paul Gray Date: 11/12/2001 - -------------------------------- R. Paul Gray **Signature of Reporting Person **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See Sections 18 U.S.C. 1001, 15 U.S.C. 78ff(a).
-----END PRIVACY-ENHANCED MESSAGE-----