-----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, AsqP9sz/aOMrsMK0RBa9r68XBFUaA9KTzKbY7bgR2PmXuV1W+IXSig9VZK2RRfIF CeMj6YVisOQ2WSOj/FlXBA== 0001209191-05-038437.txt : 20050725 0001209191-05-038437.hdr.sgml : 20050725 20050725163949 ACCESSION NUMBER: 0001209191-05-038437 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050720 FILED AS OF DATE: 20050725 DATE AS OF CHANGE: 20050725 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 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: 05971754 BUSINESS ADDRESS: STREET 1: 4650 GORDON DRIVE CITY: NAPLES STATE: FL ZIP: 33940 BUSINESS PHONE: 9412628577 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2005-07-20 0 0000870228 SYNERGY BRANDS INC SYBR 0000949119 MILLER LLOYD I III 4550 GORDON DRIVE NAPLES FL 34102 1 0 1 0 Common Stock 2005-07-20 4 J 0 40000 A 408000 I By Milfam I L.P. Common Stock 2005-07-22 4 A 0 71500 A 235782 D Common Stock 15000 I By Lloyd I. Miller, III, Trust A-2 Common Stock 15000 I By Lloyd I. Miller, III, Trust A-3 Common Stock 404272 I By Lloyd I. Miller, III, Trust A-4 Common Stock 15952 I By Lloyd I. Miller, III, Trust C Common Stock 45900 I Milfam II LP Series A Class B Preferred Stock 5000 D Series A Class B Preferred Stock 2500 I By Lloyd I. Miller, III, Trust A-2 Series A Class B Preferred Stock 2500 I By Lloyd I. Miller, III, Trust A-3 Series A Class B Preferred Stock 205000 I Milfam I LP Series B Class B Preferred Stock 2005-07-22 4 A 0 65000 A 65000 D 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 LP Common Stock Warrants (right to buy) 5.00 2001-09-24 2006-09-24 Common Stock 31250 31250 I By Lloyd I. Miller, III, Trust A-4 Milfam I L.P. ("Milfam") is a party to a certain subscription agreement dated as of July 2, 2003 with the issuer (the "Agreement") pursuant to which Milfam purchased Series A Class B Preferred Stock and Common Stock of the issuer (as reported in that certain Form 4 filed by the reporting person on July 7, 2003). The Agreement was filed as Exhibit 99.100 to Amendment No. 14 to Schedule 13D filed by the reporting person on July 11, 2003. The securities reported herein were issued to Milfam pursuant to Section 15(a) of the Agreement. No additional consideration was paid for the reported securities. 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. On July 22, 2005 the issuer accepted the reporting person's offer to subscribe to 6.5 units (each a "Unit") pursuant to a certain subscription agreement between the issuer and the reporting person. Each Unit consisted of 10,000 shares of Series B Class B Preferred Stock and 11,000 shares of Common Stock. The price per Unit was $100,000.00. /s/ David J. Hoyt Attorney-in-fact 2005-07-25 -----END PRIVACY-ENHANCED MESSAGE-----