SEC Form 4 · accession 0001470254-15-000006
Unique Fabricating, Inc. · UFAB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Peninsula Fund V Limited Partnership
10% Owner
Period of report
Aug 4, 2015
Accepted (ET)
Aug 5, 2015 · 3:12 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001617669
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Aug 4, 2015 | X | 29,232 | $3.33 | A | 1,444,632 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant to Buy Common Stock | $3.33 | Aug 4, 2015 | X | 29,232 | D | Dec 18, 2013 | Dec 18, 2023 | Common Stock | 29,232 | 0 | D |