# EDGAR Filing Document

**Accession Number:** 0001033284
**File Stem:** 0001171843-23-000950
**Filing Date:** 2023-2
**Character Count:** 7448
**Document Hash:** b8f18c6888131399e59296dd0e1d7074
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001171843-23-000950.hdr.sgml**: 20230214

**ACCESSION NUMBER**: 0001171843-23-000950

**CONFORMED SUBMISSION TYPE**: SC 13G/A

**PUBLIC DOCUMENT COUNT**: 1

**FILED AS OF DATE**: 20230214

**DATE AS OF CHANGE**: 20230214

**SUBJECT COMPANY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** UFP TECHNOLOGIES INC
- **CENTRAL INDEX KEY:** 0000914156
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **IRS NUMBER:** 042314970
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SC 13G/A
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 005-44833
- **FILM NUMBER:** 23625646

**BUSINESS ADDRESS:**
- **STREET 1:** 100 HALE STREET
- **CITY:** NEWBURYPORT
- **STATE:** MA
- **ZIP:** 01950
- **BUSINESS PHONE:** 978-352-2200

**MAIL ADDRESS:**
- **STREET 1:** 100 HALE STREET
- **CITY:** NEWBURYPORT
- **STATE:** MA
- **ZIP:** 01950
**FILED BY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** BAILLY R JEFFREY
- **CENTRAL INDEX KEY:** 0001033284

**FILING VALUES:**
- **FORM TYPE:** SC 13G/A

**MAIL ADDRESS:**
- **STREET 1:** 100 HALE STREET
- **CITY:** NEWBURYPORT
- **STATE:** MA
- **ZIP:** 01950

**UNITED STATES**

**SECURITIES AND EXCHANGE COMMISSION**

**Washington, D.C. 20549**

**SCHEDULE 13G**

**Under the Securities Exchange Act of 1934**

**(Amendment No. 21)\***

**<u>UFP Technologies, Inc.</u>**

(Name of Issuer)

Common Stock - $.01 Par Value

<u>902673102</u>

(CUSIP Number)

**<u>December 31, 2021</u>**

Date of Event which requires filing of this statement

Check the appropriate box to designate the rule pursuant to which this schedule is filed:

☐ Rule 13d-1(b)

☐ Rule 13d-1(c)

☒ Rule 13d-1(d)

\*The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 (the "Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

<u>CUSIP No. 902673102</u> <u>Page 2 of 5 pages</u>

**SCHEDULE 13G**

**Amendment No. 21**

1) Names of Reporting Persons; S.S. or I.R.S. Identification Nos. of Above Persons

<u>R. Jeffrey Bailly</u>

2) Check the Appropriate Box if a Member of a Group (See Instructions)

(a) (b) 3) SEC Use Only  

4) Citizenship or Place of Organization <u>U.S.A.</u>

Number of Shares

Beneficially Owned

By Each Reporting

Person With

5) Sole Voting Power <u>442,516</u>

6) Shared Voting Power <u> 0</u>

7) Sole Dispositive Power <u>442,516</u>

8) Shared Dispositive Power <u> 0</u>

9) Aggregate Amount Beneficially Owned by Each Reporting Person

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;442,516

10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)

11) Percent of Class Represented by Amount in Row (9)

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5.9%

12) Type of Reporting Person (See Instructions)

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;IN

<u>CUSIP No. 902673102</u> <u>Page 3 of 5 pages</u>

**SECURITIES AND EXCHANGE COMMISSION**

**SCHEDULE 13G**

**Amendment No. 21**

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| | | |
|:---|:---|:---|
| Item 1 | (a) | Name of Issuer: UFP Technologies, Inc. |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) Address of Issuer's Principal Executive Offices:

100 Hale Street

Newburyport, Massachusetts 01950

---

| | | |
|:---|:---|:---|
| Item 2 | (a) | Name of Person Filing: R. Jeffrey Bailly |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) Address of Principal Business Office or, if none, Residence:

100 Hale Street

Newburyport, Massachusetts 01950

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(c) Citizenship: USA

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(d) Title of Class of Securities: Common Stock, $.01 par value

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(e) CUSIP
NUMBER: 902673102

Item 3 If this statement is filed pursuant to §§240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filing is a:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(a) [ ] Broker or dealer registered under section
15 of the Act (15 U.S.C. 78o).

(b) [ ] Bank as defined in section 3(a)(6) of the
Act (15 U.S.C. 78c).

(c) [ ] Insurance company as defined in
section 3(a)(19) of the Act (15 U.S.C. 78c).

(d) [ ] Investment company registered under section 8 of the
Investment Company Act of 1940 (15 U.S.C. 80a-8).

(e) [ ] An investment advisor in accordance with §240.13d-1(b)(1)(ii)(E).

(f) [ ] An employee benefit plan
or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F).

(g) [ ] A parent holding company or control person in accordance
with §240.13d-1(b)(1)(ii)(G).

(h) [ ] A savings association as defined in Section 3(b) of
the Federal Deposit Insurance Act (12 U.S.C. 1813);

(i) [ ] A church plan that is excluded from the definition
if an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);

(j) [ ] Group, in accordance with §240.13d-1(b)(1)(ii)(J).

<u>CUSIP No. 902673102</u> <u>Page 4 of 5 pages</u>

---

| | | |
|:---|:---|:---|
| Item 4 | (a) | Amount Beneficially Owned: |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) Percent of Class: 5.9%

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(c) Number of Shares as to which such person has:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(i) sole power to direct the vote 442,516

(ii) shared power to vote or to direct the vote 0

(iii) sole power to dispose or to direct the disposition of 442,516

(iv) shared power to dispose or to direct the disposition of 0

---

| | |
|:---|:---|
| 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

<u>CUSIP No. 902673102</u> <u>Page 5 of 5 pages</u>

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 14, 2022 |
| Date |
| /s/ R. Jeffrey Bailly |
| Signature |
| R. Jeffrey Bailly |
| Name/Title |

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