SEC Form 4 · accession 0001617669-16-000039
Unique Fabricating, Inc. · UFAB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard L Baum Jr.
Director
Period of report
Feb 23, 2016
Accepted (ET)
Feb 23, 2016 · 4:01 pm EST
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 StockF1 | Feb 23, 2016 | X | 21,993 | $3.33 | A | 265,494 | 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 | Feb 23, 2016 | X | 21,993 | D | Dec 18, 2013 | Dec 18, 2023 | Common Stock | 21,993 | 0 | D |
| Stock Option (Right to Buy)F2 | $12.50 | holding | — | — | — | — | Aug 17, 2025 | Common Stock | 7,500 | 7,500 | D |
Explanation of responses
- F1Includes 7,500 stock options (right to buy) that were granted on August 17, 2015.
- F2The stock option vested as to 20% of the shares as of the date of grant; the option will vest as to 20% of the shares on each of the first, second, third and fourth anniversaries of the grant.