0001437749-21-008917.txt : 20210414 0001437749-21-008917.hdr.sgml : 20210414 20210414163831 ACCESSION NUMBER: 0001437749-21-008917 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201029 FILED AS OF DATE: 20210414 DATE AS OF CHANGE: 20210414 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Haverhals Jan Adriaan CENTRAL INDEX KEY: 0001856473 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14053 FILM NUMBER: 21826115 MAIL ADDRESS: STREET 1: 110 WHITE ROCK ROAD STREET 2: APT. 3304 CITY: VERONA STATE: NJ ZIP: 07044 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MILESTONE SCIENTIFIC INC. CENTRAL INDEX KEY: 0000855683 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 133545623 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 220 SOUTH ORANGE AVENUE CITY: LIVINGSTON STATE: NJ ZIP: 07039 BUSINESS PHONE: (973) 535-2717 MAIL ADDRESS: STREET 1: 220 SOUTH ORANGE AVENUE CITY: LIVINGSTON STATE: NJ ZIP: 07039 FORMER COMPANY: FORMER CONFORMED NAME: MILESTONE SCIENTIFIC INC/NJ DATE OF NAME CHANGE: 19970409 FORMER COMPANY: FORMER CONFORMED NAME: U S OPPORTUNITY SEARCH INC DATE OF NAME CHANGE: 19920703 4 1 rdgdoc.xml FORM 4 X0306 4 2020-10-29 0000855683 MILESTONE SCIENTIFIC INC. MLSS 0001856473 Haverhals Jan Adriaan C/O MILESTONE SCIENTIFIC INC. 425 EAGLE ROCK AVENUE SUITE 403 ROSELAND NJ 07068 1 President Common Stock, Par Value $0.001 2020-10-29 4 A 0 25477 1.57 A 25477 D Common Stock, Par Value $0.001 2021-01-11 4 A 0 20080 2.49 A 45557 D 45,557 of these shares are issuable to the reporting person at the termination of employment /s/ Jan Adriaan Haverhals 2021-04-14