0001579252-18-000064.txt : 20180622 0001579252-18-000064.hdr.sgml : 20180622 20180622163231 ACCESSION NUMBER: 0001579252-18-000064 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180601 FILED AS OF DATE: 20180622 DATE AS OF CHANGE: 20180622 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HOTARD EDGAR GEORGE CENTRAL INDEX KEY: 0001208957 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36051 FILM NUMBER: 18914899 MAIL ADDRESS: STREET 1: 4747 RESEARCH FOREST DRIVE STREET 2: SUITE 180-235 CITY: THE WOODLANDS STATE: TX ZIP: 77381 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jason Industries, Inc. CENTRAL INDEX KEY: 0001579252 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS MANUFACTURING INDUSTRIES [3990] IRS NUMBER: 462888322 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 833 EAST MICHIGAN STREET STREET 2: SUITE 900 CITY: MILWAUKEE STATE: WI ZIP: 53202 BUSINESS PHONE: 414-277-9300 MAIL ADDRESS: STREET 1: 833 EAST MICHIGAN STREET STREET 2: SUITE 900 CITY: MILWAUKEE STATE: WI ZIP: 53202 FORMER COMPANY: FORMER CONFORMED NAME: Quinpario Acquisition Corp. DATE OF NAME CHANGE: 20130613 4 1 wf-form4_152969953543709.xml FORM 4 X0306 4 2018-06-01 0 0001579252 Jason Industries, Inc. JASN 0001208957 HOTARD EDGAR GEORGE 833 EAST MICHIGAN STREET SUITE 900 MILWAUKEE WI 53202 1 0 0 0 Common Stock 84341 I See footnote Common Stock 65800 I By Edgar G. Hotard Management Trust Revocable Trust Restricted Stock Units 2018-06-01 4 A 0 35185 0 A Common Stock 35185.0 86076 D Warrants 12.0 2014-08-14 2019-06-30 Common Stock 23000.0 23000 I See footnote Reported 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. The 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. /s/ James M. Reeves as attorney-in-fact 2018-06-22