FORM 5
OMB Approval
OMB Number 3235-0362
Expires: February 1, 1994
U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICAL OWNERSHIP
Filed pursuant to Section 16(a) of the securities Exchange Act of 1934, Section
17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the
Investment Company Act of 1940
___ Check if no longer subject to Section 16, Form 4 or Form 5, Obligation may
continue. See Instructions
_X_ Form 3 Holdings Reported
___ Form 4 Transaction
<TABLE>
<S> <C>
1. Name and Address of Reporting Person: Clark, Frank M
2018 Oak Terrace
Sarasota, FL
34231
2. Issuer Name and Tickler or Trading Symbol: Surgical Safety Products,
Inc. SURG
3. IRS or SSN of Reporting Person (Voluntary):
4. Statement for Month/Year December 1998
5. If Amendment, Date of Original:
6. Relation of Reporting Person to Issuer: X Director
_ 10% owner
X Officer (Title):President
_ Other (Specify):
X Filed by One Reporting
Person.
_ Filed by more than One
Reporting Person.
</TABLE>
<TABLE>
<CAPTION>
TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY
OWNED
<S> <C> <C> <C>
1. Title of Security: Common Stock C.S. Warrants
2. Amount of Securities
Beneficially Owned: 50,000 200,000
3. Ownership Form;
Direct (D) or Indirect (I): D D
4. Nature of Indirect
Beneficial Ownership: N/A N/A
</TABLE>
*If the form is filed by more than one Reporting Person, see instruction 5(b)(v)
Reminder: Report on a separate Line for each class of securities beneficially
owned directly or indirectly.
<PAGE>
<TABLE>
FORM 5 (continued)
TABLE II - DERIVATIVE SECURITIES BENEFICIALLY
OWNED
<S> <C>
1. Title of Derivative Security: N/A
2. Date Exercisable and Expiration Date:
3. Title and Amount of Underlying Securities:
4. Conversion or Exercise Price of Derivative
Securities:
5. Ownership of Derivative Securities;
Direct (D) or Indirect (I):
6. Nature of Indirect Benefical Ownership:
</TABLE>
EXPLANATION OF RESPONSES:
/s/ Frank M. Clark Date: 2/15/99
- --------------------------------
**Signature of Reporting Person
Frank M. Clark
President
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. See Sections 18 U.S.C. 1001, 15 U.S.C. 78ff(a).
