| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 03/03/2015 | 3. Issuer Name and Ticker or Trading Symbol Bulova Technologies Group, Inc. [ BTGI ] | |||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Common Stock Warrants | 03/03/2015 | 03/02/2025 | Common Stock | 10,000,000 | 0.02 | D | |
| Convertible Note | 02/06/2015 | (1) | Common Stock | 40,000,000 | 0.1 | D | |
| Explanation of Responses: |
| 1. See Remarks |
| Remarks: |
| On March 4, 2015, the Issuer closed on a $4,000,000 Secured Convertible Note and Warrant Purchase Agreement dated February 6, 2015, with the Reporting Person. In connection with this funding, the Reporting Person was issued detachable and immediately exercisable 10 year Warrants to acquire up to 10,000,000 shares of the Issuer's common stock at a $.02 exercise price per share. The Note is convertible into shares of the Issuer's common stock at the following conversion rates: * From 181 days after the date of the Note through the balance of Year 1 - $.10/share * Year 2 - $.20 * Year 3 - $.30 * Year 4 - $.40 * Year 5 - $.50 For purposes of this Form 3, the Issuer is assuming a conversion price of $.10. |
| /s/ Richard Welkowitz | 05/15/2015 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. | ||
