SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
LUBIN MICHAEL A

(Last) (First) (Middle)
C/O LEXINGTON PRECISION CORPORATION
40 EAST 52ND STREET

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LEXINGTON PRECISION CORP [ LEXP ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman of the Board
3. Date of Earliest Transaction (Month/Day/Year)
12/18/2003
4. If Amendment, Date of Original Filed (Month/Day/Year)
12/22/2003
6. Individual or Joint/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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Warrants (right to buy) $3.5 12/18/2003 J(1) 468 08/01/2005 08/01/2009 Common Stock 468(2) $0(3) 468(4) I By son
Common Stock Warrants (right to buy) $3.5 12/18/2003 J(1) 390 08/01/2005 08/01/2009 Common Stock 390(2) $0(5) 390(4) I By son
Common Stock Warrants (right to buy) $3.5 12/18/2003 J(1) 156 08/01/2005 08/01/2009 Common Stock 156(2) $0(6) 156(4) I By wife through IRA rollover
Common Stock Warrants (right to buy) $3.5 12/18/2003 J(1) 546 08/01/2005 08/01/2009 Common Stock 546(2) $0(7) 546(4) I By wife through IRA
Explanation of Responses:
1. The reported securities were issued in exchange of 12 3/4% senior subordinated notes due 2000 as part of units, consisting of 12% senior subordinated notes due 2009 and warrants to purchase shares of common stock.
2. The reporting person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
3. The reported securities are part of units, consisting of a 12% senior subordinated note due 2009 in the aggregate principal amount of approximately $46,756 and warrants to purchase 468 shares of common stock issued in exchange of a 12 3/4% senior subordinated note due 2000 in the aggregate principal amount of $30,000 and approximately $16,756 in accrued interest.
4. The Form 4 of the reporting person, filed with the Securities and Exchange Commission on December 22, 2003 (the "Original Form 4") aggregated all of the warrants indirectly beneficially owned by the reporting person following the reported transaction, regardless of the form of indirect ownership of the warrants. This amendment amends the Original Form 4 by separately reporting the number of warrants beneficially owned by the reporting person under each form of beneficial ownership.
5. The reported securities are part of units, consisting of a 12% senior subordinated note due 2009 in the aggregate principal amount of approximately $38,963 and warrants to purchase 390 shares of common stock issued in exchange of a 12 3/4% senior subordinated note due 2000 in the aggregate principal amount of $25,000 and approximately $13,963 in accrued interest.
6. The reported securities are part of units, consisting of a 12% senior subordinated note due 2009 in the aggregate principal amount of approximately $15,585 and warrants to purchase 156 shares of common stock issued in exchange of a 12 3/4% senior subordinated note due 2000 in the aggregate principal amount of $10,000 and approximately $5,585 in accrued interest.
7. The reported securities are part of units, consisting of a 12% senior subordinated note due 2009 in the aggregate principal amount of approximately $54,548 and warrants to purchase 546 shares of common stock issued in exchange of a 12 3/4% senior subordinated note due 2000 in the aggregate principal amount of $35,000 and approximately $19,548 in accrued interest.
/s/ Michael A Lubin 04/22/2005
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** 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 is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.