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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO. 3)
UFP Technologies, Inc.
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(Name of Issuer)
Common Stock - $.01 Par Value
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902673102
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(CUSIP Number)
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SCHEDULE 13G
CUSIP No. 902673102
1) Names of Reporting Persons; S.S. or I.R.S. Identification Nos. of Above
Persons
Richard L. Bailly
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2) Check the Appropriate Box if a Member of a Group (See Instructions)
(a)
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(b)
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3) SEC Use Only
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4) Citizenship or Place of Organization U.S.A.
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Number of Shares 5) Sole Voting Power 268,068
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Beneficially Owned
6) Shared Voting Power 175,924
By Each Reporting ------------------------------
Person With 7) Sole Dispositive Power 268,068
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8) Shared Dispositive Power 175,924
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9) Aggregate Amount Beneficially Owned by Each Reporting Person
443,992
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10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See
Instructions)
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11) Percent of Class Represented by Amount in Row (9) 9.5%
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12) Type of Reporting Person (See Instructions) IN
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SECURITIES AND EXCHANGE COMMISSION
SCHEDULE 13G
AMENDMENT NO. 3
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: Richard L. 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 Rule 13d-1(b), or 13d-2(b),
check whether the person filing is a:
Not Applicable
Item 4(a) Amount Beneficially Owned: 443,992
(b) Percent of Class: 9.5%
(c) Number of Shares as to which such person has:
(i) sole power to direct the vote 268,068
(ii) shared power to vote or to direct the vote 175,924
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(iii) sole power to dispose or to direct the disposition of
268,068
(iv) shared power to dispose or to direct the disposition of
175,924
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
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SIGNATURE
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 10, 1997
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Date
/s/ Richard L. Bailly
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Signature
Richard L. Bailly
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Name/Title
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