SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
INFORMATION TO BE INCLUDED IN STATEMENTS FILED
PURSUANT TO RULES 13d-1(b)(c), AND (d) AND AMENDMENTS
THERETO FILED PURSUANT TO RULE 13d-2(b)
(Amendment No. 23)*
Shopsmith, Inc.
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(Name of Issuer)
Common Shares - No Par Value
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(Title of Class of Securities)
825098 10 6
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(CUSIP Number)
December 31, 2004
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(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)
[X] 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 ("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).
(Continued on following page(s))
Page 1 of 5 Pages
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CUSIP NO. 825098 10 6 13G Page 2 of 5 Pages
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1 NAME OF REPORTING PERSON John R. Folkerth, Sr.
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [ ]
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
U.S.A.
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5 SOLE VOTING POWER
NUMBER OF
367,271
SHARES ----------------------------------------------
6 SHARED VOTING POWER
BENEFICIALLY
228,507
OWNED BY ----------------------------------------------
7 SOLE DISPOSITIVE POWER
EACH
367,271
REPORTING ----------------------------------------------
8 SHARED DISPOSITIVE POWER
PERSON
228,507
WITH
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
595,778
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
22.7%
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12 TYPE OF REPORTING PERSON*
IN
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*SEE INSTRUCTION BEFORE FILLING OUT!
Item 1.
(a) Name of Issuer:
Shopsmith, Inc.
(b) Address of Issuer's Principal Executive Offices:
6530 Poe Avenue
Dayton, Ohio 45414
Item 2.
(a) Name of Person Filing:
John R. Folkerth, Sr.
(b) Address of Principal Business Office:
6530 Poe Avenue
Dayton, Ohio 45414
(c) Citizenship:
United States of America
(d) Title of Class of Securities:
Common Shares, without par value
(e) CUSIP Number:
825098 10 6
Item 3. Rules 13d-1(b) or 13d-2(b) or (c) Statement.
Not applicable.
Item 4. Ownership.
The following information concerning ownership of Common Shares is
given as of December 31, 2004:
(a) Amount Beneficially Owned:
320,212 shares directly owned
20,000 shares covered by options exercisable within 60 days
228,507 shares owned indirectly (by spouse)
27,059 shares owned indirectly (401(k) Plan)
-------
595,778 Total
(b) Percent of Class: 22.7%
(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote:
367,271 Common Shares
(ii) shared power to vote or to direct the vote:
228,507 Common Shares
(iii) sole power to dispose or to direct the disposition of:
367,271 Common Shares
(iv) shared power to dispose or to direct the disposition of:
228,507 Common Shares
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 or
Control Person.
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.
Signature.
After reasonable inquiry and to the best of my knowledge and belief,
I certify that the information set forth in this statement is true, complete and
correct.
Date: January 26, 2005
/s/ John R. Folkerth,Sr.
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JOHN R. FOLKERTH, SR.