# EDGAR Filing Document

**Accession Number:** 0001240676
**File Stem:** 0001062993-23-003790
**Filing Date:** 2023-2
**Character Count:** 6808
**Document Hash:** cec757bde6fea66fba403ca1c8a1fe1b
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001062993-23-003790.hdr.sgml**: 20230216

**ACCESSION NUMBER**: 0001062993-23-003790

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230214

**FILED AS OF DATE**: 20230216

**DATE AS OF CHANGE**: 20230216

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** ROCK MITCHELL
- **CENTRAL INDEX KEY:** 0001240676

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-12648
- **FILM NUMBER:** 23638414

**MAIL ADDRESS:**
- **STREET 1:** C/O UFP TECHNOLOGIES, INC.
- **STREET 2:** 172 EAST MAIN STREET
- **CITY:** GEORGETOWN
- **STATE:** MA
- **ZIP:** 01833

**FORMER NAME:**
- **FORMER CONFORMED NAME:** CAPLAN MITCHELL D
- **DATE OF NAME CHANGE:** 20030610
**ISSUER**: 

**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

**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

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>ROCK MITCHELL<br><sub>(Last) (First) (Middle)</sub><br>C/O UFP TECHNOLOGIES, INC.<br>100 HALE STREET<br><sub>(Street)</sub><br>NEWBURYPORT, MA 01950<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-14 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Vice President_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>UFP TECHNOLOGIES INC [ UFPT ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock, $.01 Par Value | 2023-02-14 |  | A |  | 3158<sup>(1)</sup> | A | $0 | 27353 | D |  |
| Common Stock, $.01 Par Value | 2023-02-14 |  | A |  | 2761<sup>(2)</sup> | A | $0 | 30114 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) Represents restricted stock units granted on February 15, 2022, under the Issuer's 2003 Incentive Plan subject to satisfaction of performance targets that are to be settled solely in shares of common stock. The transaction date represents the date on which the Issuer's Compensation Committee determined the performance targets were achieved. The units vest with respect to one-third of the shares on March 1, 2023 and with respect to an additional one-third on each of March 1, 2024 and 2025, so long as the recipient is in the continuous employ of the Issuer through each such respective vesting date.

(2) Represents stock unit awards granted on February 14, 2023, under the Issuer's 2003 Incentive Plan the vesting under which is solely time-based, that are to be settled solely in shares of common stock. The units vest with respect to one-third of the shares on March 1, 2024 and with respect to an additional one-third on each of March 1, 2025 and 2026, so long as the recipient is in the continuous employ of the Issuer through each such respective vesting date.

**Signature:** Patrick J. Kinney, Jr. as attorney-in-fact for Mitchell Rock  
**Date:** 2023-02-16

### Remarks:

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.**