0001161697-21-000594.txt : 20211227 0001161697-21-000594.hdr.sgml : 20211227 20211227165842 ACCESSION NUMBER: 0001161697-21-000594 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210930 FILED AS OF DATE: 20211227 DATE AS OF CHANGE: 20211227 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Matin Shahriar CENTRAL INDEX KEY: 0001396270 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-39086 FILM NUMBER: 211521173 MAIL ADDRESS: STREET 1: 96 TALAMINE COURT CITY: COLORADO SPRINGS STATE: CO ZIP: 80907 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: REPRO MED SYSTEMS INC CENTRAL INDEX KEY: 0000704440 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 133044880 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 24 CARPENTER RD CITY: CHESTER STATE: NY ZIP: 10918 BUSINESS PHONE: 845-469-2042 MAIL ADDRESS: STREET 1: 24 CARPENTER RD CITY: CHESTER STATE: NY ZIP: 10918 4/A 1 form_4.xml FORM 4/A AMENDMENT NO. 1 FOR 09-30-2021 X0306 4/A 2021-09-30 2021-10-04 0 0000704440 REPRO MED SYSTEMS INC KRMD 0001396270 Matin Shahriar C/O REPRO MED SYSTEMS, INC. 24 CARPENTER ROAD CHESTER NY 10918 1 0 0 0 Common Stock 2021-09-30 4 A 0 5263 2.85 A 10252 D This Form 4/A amendment filing corrects a typographical error found on the original Form 4 filing in Table I, Box 5. The filing of this statement shall not be construed as an admission (a) that the person filing this statement is, for the purposes of Section 16 of the Securities Exchange Act of 1934, as amended, the beneficial owner of any equity securities covered by this statement, or (b) that this statement is legally required to be filed by such person. Power of Attorney has been previously filed. /s/ Karen Fisher, Attorney-in-Fact 2021-12-27