-----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, OyGkUWlpEjogMFOWgj86YaYfGps4cXitIy73YYFps8CK2DQdZ9Sd5RAVITHWijfw tm5Lg5UMiAcXIGK7/rMsuQ== 0001209191-04-050994.txt : 20041103 0001209191-04-050994.hdr.sgml : 20041103 20041103161259 ACCESSION NUMBER: 0001209191-04-050994 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041101 FILED AS OF DATE: 20041103 DATE AS OF CHANGE: 20041103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MILLER LLOYD I III CENTRAL INDEX KEY: 0000949119 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19409 FILM NUMBER: 041116569 BUSINESS ADDRESS: STREET 1: 4650 GORDON DRIVE CITY: NAPLES STATE: FL ZIP: 33940 BUSINESS PHONE: 9412628577 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SYNERGY BRANDS INC CENTRAL INDEX KEY: 0000870228 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-GROCERIES & GENERAL LINE [5141] IRS NUMBER: 222993066 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 40 UNDERHILL BLVD CITY: SYOSSET STATE: NY ZIP: 11791 BUSINESS PHONE: 5166821980 MAIL ADDRESS: STREET 1: 40 UNDERHILL BLVD CITY: SYOSSET STATE: NY ZIP: 11791 FORMER COMPANY: FORMER CONFORMED NAME: KRANTOR CORP DATE OF NAME CHANGE: 19930328 FORMER COMPANY: FORMER CONFORMED NAME: DELTA VENTURES INC DATE OF NAME CHANGE: 19600201 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-11-01 0 0000870228 SYNERGY BRANDS INC SYBR 0000949119 MILLER LLOYD I III 4550 GORDON DRIVE NAPLES FL 34102 1 0 1 0 Common Stock 2004-11-01 2004-11-01 4 P 0 180000 A 340000 I By Milfam I, L.P. Series A Class B Preferred Stock 2004-11-01 2004-11-01 4 P 0 120000 A 220000 I By Milfam I, L.P. Common Stock 15952 I By Lloyd I. Miller, III, Trust C Common Stock 45900 I By Milfam II, L.P. Common Stock 404273 I By Lloyd I. Miller, III, Trust A-4 Common Stock 10000 I By Lloyd I. Miller, III, Trust A-2 Common Stock 10000 I By Lloyd I. Miller, III, Trust A-3 Common Stock 154282 D Series A Class B Preferred Stock 20000 D Series A Class B Preferred Stock 10000 I By Lloyd I. Miller, III, Trust A-2 Series A Class B Preferred Stock 10000 I By Lloyd I. Miller, III, Trust A-3 Common Stock Warrants (right to buy) 5.00 2001-09-24 2006-09-24 Common Stock 5000 5000 D Common Stock Warrants (right to buy) 5.00 2001-09-24 2006-09-24 Common Stock 15000 15000 I By Milfam I, L.P. Common Stock Warrants (right to buy) 5.00 2002-12-30 2012-09-30 Common Stock 31250 31250 I By Lloyd I. Miller, III, Trust A-4 The reported securities are included within 12 Units purchased by Milfam I L.P. at $100,000.00 per Unit. Each Unit consists of 10,000 shares of unregistered Series A Class B Preferred Stock and 15,000 shares of unregistered restricted Common Stock. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary 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/ David J. Hoyt Attorney-in-fact 2004-11-03 -----END PRIVACY-ENHANCED MESSAGE-----