SEC FORM
4
SEC Form 4
| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
|
| OMB APPROVAL |
| OMB Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
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|
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
| ULTRALIFE CORPORATION |
| 2000 TECHNOLOGY PARKWAY |
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
ULTRALIFE CORP
[ ULBI ]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
3. Date of Earliest Transaction
(Month/Day/Year)
11/20/2009
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
|
| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|---|
| 1. Title of Security (Instr.
3)
|
2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
|
4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
7. Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
Amount |
(A) or (D) |
Price |
| Common Stock; $.10 par value |
11/20/2009 |
|
M |
|
12,504 |
A |
$2.74
|
45,402 |
D |
|
| Common Stock; $.10 par value |
11/20/2009 |
|
S |
|
6,963 |
D |
$4.1
|
38,439 |
D |
|
| Common Stock; $.10 par value |
11/20/2009 |
|
S |
|
723 |
D |
$4.11
|
37,716 |
D |
|
| Common Stock; $.10 par value |
11/20/2009 |
|
S |
|
300 |
D |
$4.13
|
37,416 |
D |
|
| Common Stock; $.10 par value |
11/20/2009 |
|
S |
|
500 |
D |
$4.14
|
36,916 |
D |
|
| Common Stock; $.10 par value |
11/20/2009 |
|
S |
|
100 |
D |
$4.15
|
36,816 |
D |
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
|
5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
|
6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
|
8. Price of Derivative Security (Instr.
5)
|
9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
|
10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
11. Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Stock Option (Right to Buy) |
$2.74
|
11/20/2009 |
|
D |
|
|
12,504 |
11/29/2002 |
11/29/2009 |
Common Stock: $.10 oar value |
12,504 |
$0
|
0 |
D |
|
| Explanation of Responses: |
| Remarks: |
|
|
Ranjit Singh |
11/24/2009 |
|
** 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
4
(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. |
Ranjit C. Singh
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby
makes, constitutes and appoints Peter F. Comerford and
Philip A. Fain , each acting individually, as the
undersigned's true and lawful attorney-in-fact, with
full power and authority as hereinafter described on
behalf of and in the name, place and stead of the
undersigned to:
(1) prepare, execute, acknowledge, deliver and file any
and all forms including without limitation Forms 4
and 5 (including any amendments thereto) with respect to
the securities of Ulralife Corporation, a Delaware corporation
(the "Company"), with the United States Securities and
Exchange Commission, any national securities exchanges and
the Company, as considered necessary or advisable under
Section 16(a) of the Securities Exchange Act of 1934 and
the rules and regulations promulgated thereunder, as amended
from time to time (the "Exchange Act");
(2) seek or obtain, as the undersigned's representative and
on the undersigned's behalf, information on transactions in
the Company's securities from any third party, including
brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release
any such information to the undersigned's representative and
approves and ratifies any such release of information; and
(3) perform any and all other acts which in the discretion of
such attorney-in-fact are necessary or desirable for and on
behalf of the undersigned in connection with the foregoing.
The undersigned acknowledges that:
(1) this Limited Power of Attorney authorizes, but does
not require, such attorney-in-fact to act in his
discretion on information provided to such attorney-in-fact
without independent verification of such information;
(2) any documents prepared and/or executed by such
attorney-in-fact on behalf of the undersigned pursuant
to this Limited Power of Attorney will be in such form and
will contain such information and disclosure as such
attorney-in-fact, in his discretion, deems necessary
or desirable;
(3) neither the Company nor such attorney-in-fact assumes
(i) any liability for the undersigned's responsibility
to comply with the requirements of the Exchange Act, (ii) any
liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the
undersigned for profit disgorgement under Section 16(b) of the
Exchange Act; and
(4) this Limited Power of Attorney does not relieve the
undersigned from responsibility for compliance with the
undersigned's obligations under the Exchange Act, including
without limitation the reporting requirements under Section
16 of the Exchange Act.
The undersigned hereby gives and grants each of the foregoing
attorneys-in-fact full power and authority to do
and perform all and every act and thing whatsoever
requisite, necessary or appropriate to be done in and about
the foregoing matters as fully to all intents and purposes
as the undersigned might or could do if present, hereby
ratifying all that each such attorney-in-fact of, for and
on behalf of the undersigned, shall lawfully do or cause to
be done by virtue of this Limited Power of Attorney.
This Limited Power of Attorney shall remain in full force and
effect until revoked by the undersigned in a signed writing
delivered to each such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Limited
Power of Attorney to be executed as of this 23rd day of
November 2009.
/s/ Ranjit C. Singh
Signature
Ranjit C. Singh
Print Name
STATE OF NEW YORK )ss:
COUNTY OF Wayne )
On this 23rd day of November, 2009, before me personally came
Ranjit C. Singh to me known and known to me to be the
individual described in, and who executed the foregoing
instrument, and the above-named person acknowledged to me
that said person executed the same.
/s/ Donna M. Laurenza
Notary Public
