0001209191-18-041412.txt : 20180705
0001209191-18-041412.hdr.sgml : 20180705
20180705093241
ACCESSION NUMBER: 0001209191-18-041412
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20180703
FILED AS OF DATE: 20180705
DATE AS OF CHANGE: 20180705
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Grout Jeff William
CENTRAL INDEX KEY: 0001601423
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37575
FILM NUMBER: 18939630
MAIL ADDRESS:
STREET 1: C/O STAFFING 360, 641 LEXINGTON AVENUE
STREET 2: SUITE 1526
CITY: NEW YORK
STATE: NY
ZIP: 10022
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Staffing 360 Solutions, Inc.
CENTRAL INDEX KEY: 0001499717
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HELP SUPPLY SERVICES [7363]
IRS NUMBER: 680680859
STATE OF INCORPORATION: NY
FISCAL YEAR END: 1230
BUSINESS ADDRESS:
STREET 1: 641 LEXINGTON AVENUE
STREET 2: 27TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 646-507-5710
MAIL ADDRESS:
STREET 1: 641 LEXINGTON AVENUE
STREET 2: 27TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
FORMER COMPANY:
FORMER CONFORMED NAME: GOLDEN FORK CORP
DATE OF NAME CHANGE: 20100820
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-07-03
0
0001499717
Staffing 360 Solutions, Inc.
STAF
0001601423
Grout Jeff William
C/O STAFFING 360 SOLUTIONS, INC.
641 LEXINGTON AVE, 27TH FLOOR
NEW YORK
NY
10022
1
0
0
0
Common Stock, $0.00001 par value per share
2018-07-03
4
A
0
1400
0.00
A
29934
D
The reporting person received these shares pursuant to an issuance by the registrant to the directors for Board Services.
Janis Chin
2018-07-03
EX-24.4_800161
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
The undersigned constitutes and appoints David Faiman, Darren Minton and Wade
Pearson, the undersigned's true and lawful attorneys-in-fact and agents, each
acting alone, with full powers of substitution and resubstitution, for the
undersigned and in the undersigned's name, place and stead, in any and all
capacities, to:
(a) sign and submit to the Securities and Exchange Commission (the "SEC") a Form
ID, including amendments thereto, and any other documents necessary or
appropriate to obtain codes and passwords enabling the undersigned to make
electronic filings with the SEC of reports required by Section 16(a) of the
Securities Exchange Act of 1934 (the "Exchange Act");
(b) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the securities of Staffing 360 Solutions,
Inc. (the "Company") from any third party, including brokers, employee benefit
plan administrators and trustees, and the undersigned hereby authorizes any such
person to release any such information to the undersigned and approves and
ratifies any such release of information;
(c) sign any Forms 3, 4 and 5 and other filings under Section 16(a) of the
Exchange Act with respect to securities issued by the Company and to file the
same, with all exhibits thereto, and other documents in connection therewith,
with the SEC and any exchange on which securities issued by the Company may be
listed;
(d) do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable to complete and execute any such filings under
Section 16(a) of the Exchange Act, complete and execute any amendment or
amendments thereto, and file such form with the SEC and any stock exchange or
similar authority; and
(e) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned.
The undersigned acknowledges that:
(a) this Power of Attorney authorizes, but does not require, each such
attorney-in-fact to act in their discretion on information provided to such
attorney-in-fact without independent verification of such information;
(b) any documents prepared and/or executed by such attorneys-in-fact on behalf
of the undersigned pursuant to this Power of Attorney will be in such form and
will contain such information and disclosure as such attorney-in-fact, in his or
her discretion, deems necessary or desirable;
(c) neither the Company nor such attorneys-in-fact assume (i) any liability for
the undersigned's responsibility to comply with the requirements of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(d) this Power of Attorney does not relieve the undersigned from the
responsibility for compliance with the undersigned's obligations under the
Exchange Act, including without limitation the undersigned's obligations under
Section 16 of the Exchange Act.
The undersigned hereby grants unto said attorneys-in-fact and agents, each
acting alone, full power and authority to do and perform each and every act and
thing requisite and necessary to be done in and about the premises, as fully to
all intents and purposes as the undersigned might or could do in person, hereby
ratifying and confirming all that said attorneys-in-fact and agents, each acting
alone, or his substitute or substitutes, may lawfully do or cause to be done by
virtue hereof.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.
In witness whereof, the undersigned has caused this Power of Attorney to be
executed as of this 5th day of September, 2016.
By: /s/ Jeff W Grout