-----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, UetfWztX/eNsCGX+cDZKdyKfY96l3eJnuXm4z5cWLvlgPoE7IeFIJbSNDX9k9h5U CtFq1ok2IAKzVzF9UknSBw== 0001047469-99-005223.txt : 19990215 0001047469-99-005223.hdr.sgml : 19990215 ACCESSION NUMBER: 0001047469-99-005223 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19990212 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: UFP TECHNOLOGIES INC CENTRAL INDEX KEY: 0000914156 STANDARD INDUSTRIAL CLASSIFICATION: PLASTICS FOAM PRODUCTS [3086] IRS NUMBER: 042314970 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-44833 FILM NUMBER: 99534474 BUSINESS ADDRESS: STREET 1: 172 EAST MAIN ST CITY: GEORGETOWN STATE: MA ZIP: 01833 BUSINESS PHONE: 5083522200 MAIL ADDRESS: STREET 1: 172 EAST MAIN ST CITY: GEORGETOWN STATE: MA ZIP: 02135 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SHAW WILLIAM CENTRAL INDEX KEY: 0000938667 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 172 EAST MAIN STREET CITY: GEORGETOWN STATE: MA ZIP: 01833 SC 13G/A 1 SCHEDULE 13G/A UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 5) UFP TECHNOLOGIES, INC. (Name of Issuer) COMMON STOCK - $.01 PAR VALUE 902673102 (CUSIP Number) -1- SCHEDULE 13G CUSIP No. 902673102 1) Names of Reporting Persons; S.S. or I.R.S. Identification Nos. of Above Persons WILLIAM H. SHAW - -------------------------------------------------------------------------------- 2) Check the Appropriate Box if a Member of a Group (See Instructions) (a) -------------------------------------------------------------------- (b) -------------------------------------------------------------------- 3) SEC Use Only ----------------------------------------------------------- 4) Citizenship or Place of Organization U.S.A. ---------------------------------------- Number of Shares 5) Sole Voting Power 509,336 ----------------- Beneficially Owned By Each Reporting 6) Shared Voting Power 118,028 Person With ----------------- 7) Sole Dispositive Power 509,336 -------------- Shared Dispositive Power 118,028 -------------- 9) Aggregate Amount Beneficially Owned by Each Reporting Person 627,364 - -------------------------------------------------------------------------------- 10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) 11) Percent of Class Represented by Amount in Row (9) 13.4% ---------------------- 12) Type of Reporting Person (See Instructions) IN ---------------------------- -2- SECURITIES AND EXCHANGE COMMISSION SCHEDULE 13G AMENDMENT NO. 5 Item 1(a) Name of Issuer: UFP Technologies, Inc. (b) Address of Issuer's Principal Executive Offices: 172 East Main Street Georgetown, Massachusetts 01833 Item 2(a) Name of Person Filing: William H. Shaw (b) Address of Principal Business Office or, if none, Residence: 172 East Main Street Georgetown, Massachusetts 01833 (c) Citizenship: USA (d) Title of Class of Securities, Common Stock, $.01 par value (e) CUSIP NUMBER: 902673102 Item 3 If this statement is filed pursuant to Rule 13d-1(b), or 13d-2(b), check whether the person filing is a: Not Applicable Item 4 (a) Amount Beneficially Owned: 627,364 (b) Percent of Class: 13.4% (c) Number of Shares as to which such person has: (i) sole power to direct the vote 494,336 (ii) shared power to vote or to direct the vote 118,028 -3- (iii) sole power to dispose or to direct the disposition of 494,336 (iv) shared power to dispose or to direct the disposition of 118,028 Item 5 Ownership of Five Percent or Less of a Class: Not Applicable Item 6 Ownership of More than Five Percent on Behalf of Another Person: Not Applicable Item 7 Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company: Not Applicable Item 8 Identification and Classification of Members of the Group: Not Applicable Item 9 Notice of Dissolution of Group: Not Applicable Item 10 Certification Not Applicable After reasonable inquiry and to the best of my knowledge and belief, I hereby certify that the information set forth in this statement is true, complete and correct. FEBRUARY 12, 1999 --------------------------------------- Date /S/ WILLIAM H. SHAW --------------------------------------- Signature WILLIAM H. SHAW --------------------------------------- Name/Title -4- -----END PRIVACY-ENHANCED MESSAGE-----