f4042315siegel

FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
OMB APPROVAL
Washington, D.C. 20549
Check this box if no longer subject to
Section 16. Form 4 or Form 5
obligations may continue. See
Instruction 1(b).
OMB Number:
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
2. Issuer Name and Ticker or Trading Symbol
Siegel David
SURGE COMPONENTS INC [ SPRS ]
(Middle)
C/O SURGE COMPONENTS, INC.
95 EAST JEFRYN BOULEVARD
0.5
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X
3. Date of Earliest Transaction (Month/Day/Year)
(First)
December 31, 2014
Estimated average
burden hours
per response
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
1. Name and Address of Reporting Person*
(Last)
3235-0287
Expires:
04/23/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
Director
10% Owner
Officer (give title
below)
Other (specify
below)
6. Individual or Joint/Group Filing (Check Applicable Line)
X
(Street)
Form filed by One Reporting Person
Form filed by More than One Reporting Person
DEER PARK
NY
11729
(City)
(State)
(Zip)
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)
Code
Common Stock
04/23/2015
M
V
4. Securities Acquired (A) or
Disposed Of (D) (Instr. 3, 4 and 5)
Amount
(A) or
(D)
Price
5. Amount of
Securities
Beneficially Owned
Following Reported
Transaction(s)
(Instr. 3 and 4)
25,000
A
$0.25
92,000
6. Ownership
Form: Direct (D)
or Indirect (I)
(Instr. 4)
D
7. Nature of
Indirect
Beneficial
Ownership
(Instr. 4)
Table II – Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of
Derivative
2.
Conversion
or Exercise
3. Transaction
Date
(Month/Day/Year)
3A. Deemed
Execution Date,
4.
Transaction
5. Number of
Derivative
Securities
6. Date Exercisable and
Expiration Date
(Month/Day/Year)
7. Title and Amount of
Securities Underlying
8. Price of
Derivative
9. Number of
Derivative
Securities
10.
Ownership
Form:
11. Nature
of Indirect
Beneficial
Security (Instr.
3)
Price of
Derivative
Security
if any
(Month/Day/Year)
Code (Instr.
8)
Code
Stock Option
$0.25
04/23/2015
V
M
Acquired (A)
or Disposed of
(D) (Instr. 3, 4
and 5)
(A)
(D)
Derivative Security
(Instr. 3 and 4)
Date
Exercisable
Expiration
Date
25,000 05/06/2011 05/06/2015
Title
Security
(Instr. 5)
Amount
or
Number
of
Shares
Common
25,000
Stock
Beneficially
Owned
Following
Reported
Transaction(s)
(Instr. 4)
Direct (D)
or Indirect
(I) (Instr. 4)
0
D
$0
Explanation of Responses:
Remarks:
/s/ David Siegel
04/23/2015
** 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 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.
Ownership
(Instr. 4)