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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL 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 this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Stuckey Thomas M.
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(Last) (First) (Middle)
c/o Milestone Scientific Inc.
220 South Orange Avenue
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(Street)
Livingston New Jersey 07039
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Milestone Scientific Inc. AMEX - "MS"
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
September 12, 2002
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
|_| Director |_| 10% Owner
|X| Officer (give title below) |_| Other (specify below)
Chief Financial Officer
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7. Individual or Joint/Group Filing (Check Applicable Line)
|X| Form filed by One Reporting Person
|_| Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ---------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock par
value $.001 per share 9/12/02 P 2,000(1)(2) A $0.40 15,000(3)(4) D
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(Over)
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(1) The Reporting Person disclaims beneficial ownership of 1,700 of these
securities, and this report shall not be deemed an admission that the Reporting
Person is the beneficial owner of such securities for purposes of Section 16 or
for any other purpose.
(2) Out of which 500 shares are held by wife as custodian for son, 500 shares
are held by wife as custodian for second son, 500 shares are held by wife as
custodian for daughter and 200 are held by wife as custodian for second
daughter.
(3) The Reporting Person disclaims beneficial ownership of an additional 11,700
of these securities, and this report shall not be deemed an admission that the
Reporting Person is the beneficial owner of such securities for purposes of
Section 16 or for any other purpose.
(4) Out of which 1,700 shares are held by wife in IRA, 2,500 shares are held by
wife as custodian for son, 2,500 shares are held by wife as custodian for second
son, 2,500 shares are held by wife as custodian for daughter and 2,500 are held
by wife as custodian for second daughter.
*If the form is filed by more than one reporting person, see Instruction
4(b)(v).
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
SEC 1474 (2-02)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
2. Deriv- Form of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and A mount Secur- ative Nature
or Derivative 6. of Underlyi ng 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 a nd 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ----------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Common
Stock, par
Option to purchase value $.001
common stock $16.50 5/5/01 5/4/03 per share 25,000 D
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Common
Stock, par
Option to purchase value $.001
common stock $3.00 1/15/01 1/14/04 per share 21,000 D
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Common
Stock, par
Option to purchase value $.001
common stock $2.1875 (1) 7/13/04 per share 25,000 D
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Common
Stock, par
Option to purchase value $.001
common stock $2.5 (2) 7/25/06 per share 10,000 D
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Common
Stock, par
Option to purchase value $.001
common stock $.75 (3) 1/02/07 per share 7.000 D
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Explanation of Responses:
(1) Options vest as follows 8,333 on 7/13/01; 8,334 on 7/13/02; 9,3333 on
7/13/03
(2) Options vest as follows: 3,333 on 7/25/02; 3,334 on 7/25/03 and 3,333 on
7/25/04.
(3) Options vest as follows: 2,333 on 1/1/02; 2,334 on 1/1/03 and 2,333 on
1/1/04
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Thomas M. Stucky September 12, 2002
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** Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed. If
space provided is insufficient, see Instruction 6 for procedure.
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 Number.
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