4 1 y62770e4.txt LLOYD MILLER I, III / SYNERGY BRANDS, INC OMB APPROVAL ------------------------- OMB Number: 3235-0287 ------------------------- Expires: September 30,1998 ------------------------- Estimated average burden hours per response...0.5 ------------------------- 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) ________________________________________________________________________________ 1. Name and Address of Reporting Person* Miller, III Lloyd I. -------------------------------------------------------------------------------- (Last) (First) (Middle) 4550 Gordon Drive -------------------------------------------------------------------------------- (Street) Naples FL 34102 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Synergy Brands, Inc - SYBR -------------------------------------------------------------------------------- ________________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person, if an entity (Voluntary) ###-##-#### ________________________________________________________________________________ 4. Statement for Month/Year July/2002 --------------------------------------------------------------------------- ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [X] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ________________________________________________________________________________ 7. 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 ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (Month/Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 7/15/02 P 3,100 A $0.81 I Common Stock 7/9/02 P 3,000 A $0.82 422,485(1) I By Lloyd I. Miller, III Trust A-4 ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 7/3/02 P 15,000 A $0.85 434,530 D ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 142,000(1) I By Dail Miller ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 136,600(1) I By Milfam II, L.P. ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 47,008(1) I By Lloyd I. Miller, III, Trust C ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 240,000(1) I By Milfam I, L.P. ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ===================================================================================================================================
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). 1 of 2 (OVER) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants $1.25 9/24/01 A V 20,000 Immed. 9/24/06 Common 20,000 20,000(1) I By Dail (right to buy) Stock Miller ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants $1.25 9/24/01 A V 60,000 Immed. 9/24/06 Common 60,000 60,000(1) I By (right to buy) Stock Milfam I L.P. ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants $1.25 9/24/01 A V 20,000 Immed. 9/24/06 Common 20,000 20,000 D (right to buy) Stock ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: (1) The reporting person disclaims beneficial ownership of these securities except to the extent of his primary interest therein. This filing shall not be deemed an admission that the reporting person is, for purposes of Section 16 of the Act or otherwise, the beneficial owner of any equity securities covered by this filing.
/s/ Lloyd I. Miller, III August 6, 2002 --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. 2 of 2