SEC Form 4
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
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
SAMUELS LEONARD

(Last) (First) (Middle)
1011 CENTENNIAL ROAD

(Street)
PENN VALLEY PA 19072

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
DAIS ANALYTIC CORP [ DLYT ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
09/17/2009
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 09/17/2009 10/09/2009 P 800,000 A $0.25 4,865,212 D
Common Stock 10/09/2009 10/09/2009 C 291,178 A $0.2 4,865,212 D
Common Stock 10/09/2009 10/09/2009 C 290,623 A $0.2 4,865,212 D
Common Stock 10/09/2009 10/09/2009 C 289,945 A $0.2 4,865,212 D
Common Stock 10/09/2009 10/09/2009 C 1,743,740 A $0.2 4,865,212 D
Common Stock 10/09/2009 10/09/2009 C 144,726 A $0.2 4,865,212 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
12/11/07 Notes $0.2 10/09/2009 10/09/2009 C 50,000 12/11/2007 10/09/2009 DAIS Common 291,178 $0 0 D
09/17/07 Warrants $0.75 09/17/2007 09/17/2009 P 80,000 09/17/2009 09/17/2014 DAIS Common 80,000 $0 80,000 D
12/20/07 Notes $0.2 10/09/2009 10/09/2009 C 50,000 12/20/2007 10/09/2009 DAIS Common 290,623 $0 0 D
12/31/07 Notes $0.2 10/09/2009 10/09/2009 C 50,000 12/31/2007 10/09/2009 DAIS Common 289,945 $0 0 D
12/20/07 Notes $0.2 10/09/2009 10/09/2009 C 300,000 12/20/2007 10/09/2009 DAIS Common 1,743,740 $0 0 D
12/31/07 Notes $0.2 10/09/2009 10/09/2009 C 250,000 12/31/2007 10/09/2009 DAIS Common 1,449,726 $0 0 D
1/21/08 Warrant $0.25 10/09/2009 10/09/2009 S 125,000 01/21/2008 01/21/2013 DAIS Common 125,000 $0 0 D
1/21/08 Note $0.2 10/09/2009 10/09/2009 S 25,000 01/21/2008 10/09/2009 DAIS Common 138,377 $25,000 0 D
10/09/09 Warrant $0.75 10/09/2009 10/09/2009 P 150,000 10/09/2009 10/09/2014 DAIS Common 150,000 $0 350,000 D
10/09/09 Warrant $0.75 10/09/2009 10/09/2009 P 125,000 10/09/2009 10/09/2014 DAIS Common 125,000 $0 350,000 D
10/09/09 Warrant $0.75 10/09/2009 10/09/2009 P 75,000 10/09/2009 10/09/2009 DAIS Common 75,000 $0 0 D
Explanation of Responses:
Remarks:
Leonard Samuels IRA held 3,193,466 shares, 275,000 75 cent warrants, and 2,750,000 25 cent warrants. The rest of holdings are joint with Leah Kaplan-Samuels, my wife. The new 75 cent warrants were issued at zero cost as an incentive to purchase new shares for cash and convert all notes.
/s/ Leonard Samuels 10/12/2009
** Signature of Reporting Person Date
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).
** 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 is insufficient, see Instruction 6 for procedure.
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 Number.