SEC Form 4 · accession 0001579252-16-000193
Jason Industries, Inc. · JASN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Edgar George Hotard
Director
Period of report
Jul 9, 2016
Accepted (ET)
Jul 12, 2016 · 5:30 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 Stock | holding | — | — | — | 65,800 | I | By Edgar G. Hotard Management Trust Revocable Trust | |
| Common StockF1 | holding | — | — | — | 84,341 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF2 | — | Jul 9, 2016 | A | 26,557 | A | — | — | Common Stock | 26,557 | 50,891 | D |
| WarrantsF1 | $12.00 | holding | — | — | — | Aug 14, 2014 | Jun 30, 2019 | Common Stock | 23,000 | 23,000 | I |
Explanation of responses
- F1Reported securities are held by Hotard Family Interests, Ltd. Reporting person does not have voting or dispositive control over such securities and disclaims beneficial ownership except to the extent of his pecuniary interest therein. 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.
- F2The restricted stock units vest on the one (1) year anniversary of the applicable grant date, assuming continued service. The board of directors or applicable committee of the board may, in its sole discretion, provide for accelerated vesting of the restricted stock units at any time and for any reason. Subject to the board or board committee's discretion to accelerate vesting, all unvested restricted stock units shall be immediately forfeited upon the reporting person's termination of service for any reason. Additionally, all restricted stock units shall become fully vested upon the occurrence of a change of control of Jason Industries, Inc., provided that the reporting person has not been terminated prior to such change of control. Vested restricted stock units will settle in the form of shares of common stock, cash or a combination thereof on the date that is six (6) months following the date of termination of service.
Remarks
This filing corrects the reporting person's Table I ownership of the issuer's common stock to reflect that 53,800 shares of common stock, that had been previously reported as being owned directly on the reporting person's Form 3 filed on August 8, 2013 and Form 4s filed on August 16, 2013, September 23, 2014, July 9, 2015 and August 11, 2015, are actually owned indirectly by a revocable trust.