Statement of Changes in Beneficial Ownership (4)
May 26 2015 - 4:05PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
Shapiro Gary L
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2. Issuer Name
and
Ticker or Trading Symbol
Bulova Technologies Group, Inc.
[
BTGI
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
2R JUDITH'S FANCY
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/4/2015
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(Street)
CHRISTIANSTED, VI 00824
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Warrant
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$0.02
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3/4/2015
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P
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3000000
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3/4/2015
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3/3/2025
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Common Stock
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3000000
(1)
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$0
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23147570
(2)
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D
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Warrant
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$0.02
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3/4/2015
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P
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3000000
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3/4/2015
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3/3/2025
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Common Stock
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3000000
(1)
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$0
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23147570
(2)
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D
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Explanation of Responses:
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(
1)
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Represents warrants to acquire 3,000,000 shares of the Issuer's common stock issued to each of the Reporting Person and his wife, Colleen Stacy Shapiro, held in Roth IRA'S.
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(
2)
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This amount includes other warrants of the Issuer's previously issued at varying times, exercise prices and expiration date as reported on Form 5 filed on December 12, 2014.
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Remarks:
The filing of this Report shall not be an admission that the Reporting Person is the beneficial owner of any other securities of the Issuer for Section 16 or any other purposes. The above amounts exclude conversion privileges for outstanding notes of the Issuer held by the Reporting Persons because they are not convertible for 181 days from February 6, 2015. See Issuer's Form 8-K, dated April 17, 2015.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Shapiro Gary L
2R JUDITH'S FANCY
CHRISTIANSTED, VI 00824
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X
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Signatures
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/s/ Gary L. Shapiro
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3/5/2015
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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 control number.
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