-----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, O7o0GUNAwIvjQFzFv/uF9/UThPVkyEdU+I41J9+1UwEJ8FCFjlpJed8hPKoa42w2 NWc6a/7w1gmScFE/4dTacQ== 0000948520-08-000081.txt : 20080514 0000948520-08-000081.hdr.sgml : 20080514 20080514095829 ACCESSION NUMBER: 0000948520-08-000081 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20080514 DATE AS OF CHANGE: 20080514 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SPAN AMERICA MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000718924 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 570525804 STATE OF INCORPORATION: SC FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-37196 FILM NUMBER: 08829793 BUSINESS ADDRESS: STREET 1: 70 COMMERCE DR STREET 2: P O BOX 5231 CITY: GREENVILLE STATE: SC ZIP: 29615 BUSINESS PHONE: 8642888877 MAIL ADDRESS: STREET 1: 70 COMMERCE DR STREET 2: PO BOX 5231 CITY: GREENVILLE STATE: SC ZIP: 29606 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ZUCKER JERRY CENTRAL INDEX KEY: 0001040211 FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: C/O THE INTERTECH GROUP INC STREET 2: 4838 JENKINS AVE CITY: N CHARLESTON STATE: SC ZIP: 29405 MAIL ADDRESS: STREET 1: C/O INTERTECH GROUP INC STREET 2: 4838 JENKINS AVE CITY: N CHARLESTON STATE: SC ZIP: 29405 SC 13D/A 1 sc13d-a4span.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13D Under the Securities Exchange Act of 1934 (Amendment No. 4)* Span-America Medical Systems, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 846396109 - -------------------------------------------------------------------------------- (CUSIP Number) The Estate of Jerry Zucker c/o The Inter Tech Group, Inc. Post Office Box 5205 North Charleston, SC 29405 (843) 744-5174 - -------------------------------------------------------------------------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) with a copy to: George S. King, Jr., Esq. Haynsworth Sinkler Boyd, P.A. Post Office Box 11889, Columbia, South Carolina 29211 (803) 779-3080 April 12, 2008 - -------------------------------------------------------------------------------- (Date of Event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of Sections 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box [ ]. *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). SCHEDULE 13D CUSIP NO. 846 396 109 PAGE 2 OF 3 1. NAME OF REPORTING PERSON Jerry Zucker - -------------------------------------------------------------------------------- 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [ ] (b) [ ] - -------------------------------------------------------------------------------- 3. SEC USE ONLY - -------------------------------------------------------------------------------- 4. SOURCE OF FUNDS PF, OO - -------------------------------------------------------------------------------- 5. CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) [ ] - -------------------------------------------------------------------------------- 6. CITIZENSHIP OR PLACE OF ORGANIZATION USA - -------------------------------------------------------------------------------- NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH 7. SOLE VOTING POWER 208,800 --------------------------------------------------------------------------- 8. SHARED VOTING POWER 0 --------------------------------------------------------------------------- 9. SOLE DISPOSITIVE POWER 208,800 --------------------------------------------------------------------------- 10. SHARED DISPOSITIVE POWER 0 --------------------------------------------------------------------------- 11. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 208,800 - -------------------------------------------------------------------------------- 12. CHECK IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions ) [ ] - -------------------------------------------------------------------------------- 13. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 7.5% - -------------------------------------------------------------------------------- 14. TYPE OF REPORTING PERSON (See Instructions) IN - -------------------------------------------------------------------------------- PAGE 3 OF 3 Item 5 of the Schedule 13D filed by Jerry Zucker with respect to his ownership of the common stock of Span-America Medical Systems, Inc., as amended, is hereby amended to add following: Item 5. Interest in Securities of the Issuer (e) In 2007 Mr Zucker transferred the 208,800 shares of common stock of the Issuer as to which this filing relates to a trust of which he was then the sole trustee. Upon the death of Mr. Zucker on April 12, 2008, Anita G. Zucker became the sole trustee of the trust and thereby acquired, as trustee, the shares of common stock as to which this filing relates. Signature After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date: May 13, 2008 s/ Anita G. Zucker --------------------------------------------- Anita G. Zucker Personal Representative of the Estate of Jerry Zucker -----END PRIVACY-ENHANCED MESSAGE-----