SEC Form 4 · accession 0000899243-15-004060
Jason Industries, Inc. · JASN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffry N Quinn
Director · 10% Owner · Other
Period of report
Aug 24, 2015
Accepted (ET)
Aug 26, 2015 · 4:45 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001579252
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F7,F8 | Jun 10, 2015 | G | 34,257 | $0.00 | D | 15,743 | I | See footnote |
| Common StockF7,F8 | Aug 24, 2015 | J | 15,743 | $4.81 | D | 0 | I | See footnote |
| Common StockF1,F4,F7,F8 | Jun 10, 2015 | G | 34,000 | $0.00 | D | 3,736,955 | I | See footnote |
| Common StockF5,F7,F8 | Aug 24, 2015 | J | 15,743 | $4.81 | A | 3,752,698 | I | See footnote |
| Common StockF3 | holding | — | — | — | 97,560 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF6,F7,F8 | $12.00 | holding | — | — | — | Aug 14, 2014 | Jun 30, 2019 | Common Stock | 532,551 | 532,551 | I |
Explanation of responses
- F1On June 10, 2015, the Jeffry N. Quinn Revocable Trust dated July 28, 2000, as amended, and The Quinn Group gifted shares as part of a charitable contribution.
- F2For estate planning purposes, on August 24, 2015, 15,743 shares of Jason Industries, Inc. common stock were sold by the Jeffry N. Quinn Revocable Trust dated July 28, 2000, as amended, to the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Grace Quinn and to the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Sarah Quinn.
- F3Includes 97,560 shares held by Jeffry Quinn, IRA.
- F4The balance has been updated to correct an overstatement of the securities beneficially owned by The Quinn Group and the Jeffry N. Quinn Family Trusts uad 8/10/2012 included in the Reporting Person's Form 4 filed on September 23, 2014.
- F5Includes 3,700,285 shares held by The Quinn Group, 26,207 shares held by the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Grace Quinn and 26,206 shares held by the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Sarah Quinn.
- F6Includes 522,551 warrants held by The Quinn Group, 5,000 warrants held by the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Grace Quinn and 5,000 warrants held by the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Sarah Quinn.
- F7Jeffry N. Quinn maintains control over the securities beneficially owned by the Jeffry N. Quinn Revocable Trust dated July 28, 2000, as amended, The Quinn Group, the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Grace Quinn and the Jeffry N. Quinn Family Trust uad 8/10/2012 FBO Sarah Quinn, and, consequently, Mr. Quinn may be deemed to be the beneficial owner of such securities.
- F8The Reporting Person disclaims beneficial ownership except to the extent of its pecuniary interest therein, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
Remarks
Exhibit 24 - Power of Attorney