-----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, WUPL37JlgJPyYY4/9Fy8x0Y21//GsbNsJooDpgUc2HMjSIKEWWqjfdtwV1yX0c5c 6jP8LpNd456dNh6yQXqbFA== 0001077357-99-000017.txt : 19990219 0001077357-99-000017.hdr.sgml : 19990219 ACCESSION NUMBER: 0001077357-99-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990101 FILED AS OF DATE: 19990218 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: 4 SEC ACT: SEC FILE NUMBER: 000-24921 FILM NUMBER: 99544903 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] DIRECTOR IRS NUMBER: 650565144 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 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 4 1 STATEMENT OF CHANGE FORM 4 OMB Approval OMB Number 3235-0287 Expires: February 1, 1994 U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICAL OWNERSHIP 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 1. Name and Address of Reporting Person: Lawrence, Donald K 2018 Oak Terrace Sarasota, FL 34231 2. Issuer Name and Tickler or Trading Symbol: Surgical Safety Products, Inc. SURG 3. IRS or SSN of Reporting Person (Voluntary): 4. Statement for Month/Year December 1998 5. If Amendment, Date of Original: 6. Relation of Reporting Person to Issuer: X Director _ 10% owner X Officer (Title):Exec.VP Secretary _ Other (Specify): X Filed by One Reporting Person. _ Filed by more than One Reporting Person.
TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED 1. Title of Security: C.S. Warrants 2. Transaction Date (M/D/Y): 1/1/99 3. Transaction Code (Instr 8): 8 4. Securities Acquired (A) or Disposed (D) Amount: (A) or (D): Price: 5. Amount of Securities Beneficially Owned: 10,000 6. Ownership Form; Direct (D) or Indirect (I): D 7. Nature of Indirect Beneficial Ownership: N/A
*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. FORM 5 (continued) TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED 1. Title of Derivative Security: N/A 2. Conversion or Exercise Price of Derivative Security: 3. Transaction Date (M/D/Y): 4. Transaction Code: V: 5. Number of Derivative Securities Aquired (A) or Disposed of (D): 6. Date Exercisable: Expiration Date: 7. Title of Underlying Securities: Amount or number of Shares: 8. Price of Derivative Security: 9. Number of Derivative Securities Beneficially Owned at end of Month: 10. Ownership of Derivative Securities; (D) Direct or (I) Indirect: 11. Nature of Indirect Benefical Ownership:
EXPLANATION OF RESPONSES: /s/ Donald K. Lawrence Date: 2/15/99 - -------------------------------- **Signature of Reporting Person Donald K. Lawrence Executive Vice President **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-----