| FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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 |
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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
| Form 3 Holdings Reported. | |||||||||||||||||
| Form 4 Transactions Reported. | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
ALLIED HEALTHCARE PRODUCTS INC [ AHPI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2011 | ||||||||||||||||||||||||||
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4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 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 at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
| Amount | (A) or (D) | Price | |||||||||||||
| Common Stock | 4,000 | I | IRA(1) | ||||||||||||
| Common Stock | 40,074 | D | |||||||||||||
| Common Stock | 188,855(1) | I | Spouse | ||||||||||||
| Common Stock | 118,203 | I | Trust(2) | ||||||||||||
| Common Stock | 447,361 | I | Trust(3) | ||||||||||||
| Common Stock | 990,079 | I | Limited Partnership(4) | ||||||||||||
| Common Stock | 15,853 | I | Corporation(5) | ||||||||||||
| Common Stock | 12/31/2011 | J(7) | 13,421 | A | (7) | 239,587(8) | I | Trust(6) | |||||||
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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| 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) | |||
| (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
| Explanation of Responses: |
| 1. The reporting person disclaims any economic benefit in such shares. |
| 2. Owned by a trust for the benefit of the reporting person and for which the reporting person acts as co-trustee. |
| 3. Owned by a trust for the benefit of a sibling of the reporting person and for which the reporting person acts as co-trustee. The reporting person disclaims any economic benefit in such shares. |
| 4. Owned by a family limited partnership of which the reporting person acts as one of several general partners. Number of shares reported includes all shares held by limited partnership. The reporting person disclaims beneficial ownership of shares held by the limited partnership in excess of the reporting person's proportionate interest as determined pursuant to Rule 16a-1(2)(ii)(B). |
| 5. Owned by a corporation controlled by the reporting person. |
| 6. Owned by trusts for which the reporting person acts as co-trustee and with respect to which the reporting person and/or members of his immediate family have a contingent remainder interest. The reporting person disclaims any economic benefit in such shares. |
| 7. Shares acquired in a transfer for no consideration among the reporting person and members of the reporting person's family, including shares transferred in connection with a liquidation of a family limited partnership. Reporting person timely reported the disposition of these shares from a family limited partnership on a Form 4 filed on January 16, 2012. Reporting person inadvertently failed to report that the shares were transferred to the trusts described in Note 6, as his pecuniary interest results only from contingent remainder interests in the trusts held by certain members of his immediate family who do not share his household. |
| 8. Total reported shares held by these trusts as of December 31, 2011 includes results of transactions reported late on a Form 4/A filed November 15, 2013. |
| John D. Weil | 12/20/2013 | |
| ** 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. | ||