0001564590-17-011873.txt : 20170531 0001564590-17-011873.hdr.sgml : 20170531 20170530203135 ACCESSION NUMBER: 0001564590-17-011873 CONFORMED SUBMISSION TYPE: SD PUBLIC DOCUMENT COUNT: 2 13p-1 1.01 20161231 1.02 20161231 FILED AS OF DATE: 20170531 DATE AS OF CHANGE: 20170530 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Great Basin Scientific, Inc. CENTRAL INDEX KEY: 0001512138 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 830361454 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SD SEC ACT: 1934 Act SEC FILE NUMBER: 001-36662 FILM NUMBER: 17879274 BUSINESS ADDRESS: STREET 1: 420 E. SOUTH TEMPLE STREET 2: SUITE 520 CITY: SALT LAKE CITY STATE: UT ZIP: 84111 BUSINESS PHONE: (801) 990-1055 MAIL ADDRESS: STREET 1: 420 E. SOUTH TEMPLE STREET 2: SUITE 520 CITY: SALT LAKE CITY STATE: UT ZIP: 84111 SD 1 gbsn-sd.htm SD gbsn-sd.htm

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM SD

SPECIALIZED DISCLOSURE REPORT

CONFLICT MINERALS

 

GREAT BASIN SCIENTIFIC, INC.

(Exact name of the registrant as specified in its charter)

 

 

 

 

 

 

 

 

 

 

Delaware

  

001-36662

  

83-0361454

(State or other jurisdiction

of incorporation or organization)

  

(Commission

File Number)

  

(IRS Employer

Identification No.)

 

 

 

 

 

 

 

420 E. South Temple, Suite 520

Salt Lake City, UT

  

84111

(Address of principal executive offices)

  

(Zip code)

 

 

Jeffrey A. Rona

(801) 990-1055

(Name and telephone number, including area code, of

the person to contact in connection with this report.)

 

 

 

 

Check the appropriate box to indicate the rule pursuant to which this form is being filed, and provide the period to which the information in this form applies:

 

☒

Rule 13p-1 under the Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from January 1, 2016 to December 31, 2016.

 

 

 

Section 1. Conflict Minerals Disclosure

Item 1.01 Conflict Minerals Disclosure and Report

Great Basin Scientific, Inc.’s Conflict Mineral Report, filed as Exhibit 1.01 hereto, is publicly available on its website at www.gbscience.com/investors as well as on the Securities and Exchange Commission’s EDGAR database at www.sec.gov.  The content of any website referred to in this Form, and any information accessible through such websites, is included for general information only and is not incorporated by reference in this Form nor deemed filed with the Securities and Exchange Commission.

 

Item 1.02

Exhibit

The Conflict Minerals Report required by Item 1.01 is filed as Exhibit 1.01 to this Form.

Section 2. Exhibits

 

Item 2.01

Exhibits

Exhibit 1.01 – Conflict Minerals Report as required by Items 1.01 and 1.02 of this Form.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the duly authorized undersigned.

 

 

 

 

 

 

GREAT BASIN SCIENTIFIC, INC.

 

 

By:

 

/s/ Jeffrey A. Rona

 

 

 

 

 

Name:

 

Jeffrey A. Rona

 

 

Title:

 

Chief Financial Officer

May 30, 2017

 

 EX-1.01 2 gbsn-ex101_6.htm EX-1.01 gbsn-ex101_6.htm

 

Exhibit 1.01

 

Section 1 - Conflict Minerals Disclosure

 

Item 1.01 Conflict Minerals Disclosure and Report

 

Conflict Minerals Disclosure

 

For the calendar year 2016, we assessed whether any conflict minerals, as defined in Item 1.01(d)(3) of Form SD, were necessary to the functionality or production of a product we manufactured or contracted to be manufactured.  We determined that certain conflict minerals were necessary to the functionality of products we manufactured.

 

Accordingly, we conducted in good faith a reasonable country of origin inquiry regarding the conflict minerals in our products for the calendar year 2016.  We designed our inquiry to determine whether such conflict minerals originated in the Democratic Republic of the Congo or an adjoining country, as defined in Item 1.01(d)(1) of Form SD, or were from recycled or scrap sources, as defined in Item 1.01(d)(6) of Form SD.  We contacted by telephone each of the four vendors we identified as providing parts to us that could contain conflict minerals and we received written responses from each.  A summary of the responses is as follows.

 

Category of Description of the Certification Regarding the Vendor’s Provided Products

No. of Vendors Responding by Category

Percentage of Vendors Responding by Category

 

 

 

Contained no amount of conflict minerals

2

50%

 

 

 

Contained some amount of conflict mineral(s) but all such conflict mineral(s) came from recycled or scrap sources

 

--

 

--

 

 

 

Contained some amount (including de minimis amounts) of one or more conflict mineral(s), but such conflict mineral(s) did not originate in the Democratic Republic of the Congo or an adjoining country

 

2

 

50%

 

 

 

Contained some amount (including de minimis amounts) of one or more conflict mineral(s), with such conflict mineral(s) originating or possibly originating in the Democratic Republic of the Congo or an adjoining country

 

--

 

--

 

Based on our good faith, reasonable country of origin inquiry, we do not know or have reason to believe that the conflict minerals in our products have originated from the Democratic Republic of the Congo or an adjoining country.

 

This Conflicts Minerals Disclosure is also posted on our website at http://www.gbscience.com/investors.

 


 

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

May 30, 2017

GREAT BASIN SCIENTIFIC, INC.

 

 

 

By: /s/ Jeffrey A. Rona

     Jeffrey A. Rona

      Chief Financial Officer