SEC 1745
(02-02)


Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.

 

 

UNITED STATES

OMB APPROVAL

 

SECURITIES AND EXCHANGE COMMISSION

OMB Number:
3235-0145

 

Washington, D.C. 20549

Expires: December 31, 2005

 

SCHEDULE 13G

Estimated average burden hours per response. . 11

 

Under the Securities Exchange Act of 1934
(Amendment No.  2)*

 

UFP Technologies, Inc.

(Name of Issuer)

 

Common Stock - $.01 Par Value

(Title of Class of Securities)

 

902673102

(CUSIP Number)

 

December 31, 2002

(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

[     ]

Rule 13d-1(b)

[ X ]

Rule 13d-1(c)

[     ]

Rule 13d-1(d)

 

*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 the disclosures provided in a prior cover page.

 

The information required in 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).

 

 

 

CUSIP No.  902673102

 

 

1.

Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only)
R. Jeffrey Bailly

 

 

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
Beneficially
Owned by
Each
Reporting
Person With

5.

Sole Voting Power
794,092

 

6.

Shared Voting Power
120,090

 

7.

Sole Dispositive Power
794,092

 

8.

Shared Dispositive Power
120,090

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
914,182

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  [     ]

 

 

11.

Percent of Class Represented by Amount in Row (9)
18.9%

 

 

12.

Type of Reporting Person (See Instructions)
IN

 

 

2

 

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
R. Jeffrey Bailly

 

(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 §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

 

(a)

[  ]

Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).

 

(b)

[  ]

Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).

 

(c)

[  ]

Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).

 

(d)

[  ]

Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8).

 

(e)

[  ]

An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);

 

(f)

[  ]

An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F);

 

(g)

[  ]

A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G);

 

(h)

[  ]

A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);

 

(i)

[  ]

A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940

 

 

3

 

 

 

 

(15 U.S.C. 80a-3);

 

(j)

[  ]

Group, in accordance with §240.13d-1(b)(1)(ii)(J).

Item 4.

Ownership

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

 

(a)

Amount beneficially owned:  914,182

 

(b)

Percent of class:  18.9%

 

(c)

Number of shares as to which the person has:

 

 

(i)

Sole power to vote or to direct the vote  794,092

 

 

(ii)

Shared power to vote or to direct the vote  120,090

 

 

(iii)

Sole power to dispose or to direct the disposition of  794,092

 

 

(iv)

Shared power to dispose or to direct the disposition of  120,090

 

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 or Control Person

 

Not Applicable

 

Item 8.

Identification and Classification of Members of the Group

 

Not Applicable

 

Item 9.

Notice of Dissolution of Group

 

Not Applicable

 

 

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Item 10.

Certification

 

(a)

Not Applicable

 

 

 

 

(b)

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as participant in any transaction having that purpose or effect.

 

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.

 

 

February 12, 2003

 

Date

 


/s/ R. Jeffrey Bailly

 

Signature

 


R. Jeffrey Bailly

 

Name/Title

 

 

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