- Initial Statement of Beneficial Ownership (3)
February 06 2009 - 5:05PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Expires:
February 28, 2011
Estimated average burden
hours per response...
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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(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Nikoo Nezam
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2. Date of Event Requiring Statement (MM/DD/YYYY)
1/28/2009
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3. Issuer Name
and
Ticker or Trading Symbol
BLONDER TONGUE LABORATORIES INC [BDR]
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(Last)
(First)
(Middle)
C/O BLONDER TONGUE LABORATORIES, INC., ONE JAKE BROWN ROAD
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
VP Advanced Digital Tech /
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(Street)
OLD BRIDGE, NJ 08857
(City)
(State)
(Zip)
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5. 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 Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock par value $0.001
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10188
(1)
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D
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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. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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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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Employee Stock Option (right to buy)
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(2)
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8/18/2009
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Common Stock par value $0.001
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2000
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$6.34
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D
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Employee Stock Option (right to buy)
(1)
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(2)
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8/18/2009
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Common Stock par value $0.001
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3000
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$6.34
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I
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By Spouse.
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Employee Stock Option (right to buy)
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(3)
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8/13/2010
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Common Stock par value $0.001
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20000
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$6.75
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D
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Employee Stock Option (right to buy)
(1)
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(3)
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8/13/2010
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Common Stock par value $0.001
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10000
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$6.75
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I
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By Spouse.
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Employee Stock Option (right to buy)
(1)
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(4)
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2/14/2011
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Common Stock par value $0.001
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10000
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$2.88
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I
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By Spouse.
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Employee Stock Option (right to buy)
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(5)
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3/25/2012
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Common Stock par value $0.001
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17500
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$3.43
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D
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Employee Stock Option (right to buy)
(1)
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(5)
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3/25/2012
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Common Stock par value $0.001
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17500
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$3.43
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I
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By Spouse.
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Employee Stock Option (right to buy)
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(6)
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3/28/2015
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Common Stock par value $0.001
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5000
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$3.84
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D
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Employee Stock Option (right to buy)
(1)
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(6)
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3/28/2015
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Common Stock par value $0.001
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15000
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$3.84
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I
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By Spouse.
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Employee Stock Option (right to buy)
(1)
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(7)
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3/27/2016
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Common Stock par value $0.001
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35000
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$1.905
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I
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By Spouse.
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Employee Stock Option (right to buy)
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(8)
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4/17/2016
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Common Stock par value $0.001
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6500
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$2.245
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D
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Employee Stock Option (right to buy)
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(9)
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4/2/2017
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Common Stock par value $0.001
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11000
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$1.98
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D
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Employee Stock Option (right to buy)
(1)
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(9)
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4/2/2017
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Common Stock par value $0.001
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25000
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$1.98
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I
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By Spouse.
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Employee Stock Option (right to buy)
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(10)
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11/16/2018
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Common Stock par value $0.001
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10000
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$.755
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D
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Employee Stock Option (right to buy)
(1)
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(10)
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11/16/2013
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Common Stock par value $0.001
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10000
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$.8305
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I
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By Spouse.
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Explanation of Responses:
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(
1)
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These shares are jointly owned by the reporting person and his spouse, Emily Nikoo, who is a reporting officer of the issuer.
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(
2)
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The stock option vested in three equal installments of one-third each on August 19, 2000, 2001 and 2002.
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(
3)
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The stock option vested in three equal installments of one-third each on August 15, 2001, 2002 and 2003.
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(
4)
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The stock option vested in three equal installments of one-third each on February 16, 2002, 2003 and 2004.
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(
5)
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The stock option vested in three equal installements of one-third each on March 26, 2003, 2004 and 2005.
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(
6)
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The stock otion vested in three equal installments of one-third each on March 29, 2006, 2007 and 2008.
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(
7)
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The stock option vests in three equal installments of one-third each. The first and second installments vested on March 28,
2007 and 2008. The third installment will vest on March 28, 2009.
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(
8)
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The stock option vests in three equal installments of one-third each. The first and second installments vested on April 18,
2007 and 2008. The third installment will vest on April 18, 2009.
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(
9)
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The stock option vests in three equal installments of one-third each. The first installment vested on April 3, 2008. The
second and third installments will vest on April 3, 2009 and 2010.
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(
10)
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The stock option will vest in three equal installments of one-third each on November 17, 2009, 2010 and 2011.
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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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Nikoo Nezam
C/O BLONDER TONGUE LABORATORIES, INC.
ONE JAKE BROWN ROAD
OLD BRIDGE, NJ 08857
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VP Advanced Digital Tech
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Signatures
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/s/ Nazem Nikoo
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2/5/2009
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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 5(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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