0001579252-15-000085.txt : 20150806 0001579252-15-000085.hdr.sgml : 20150806 20150806162556 ACCESSION NUMBER: 0001579252-15-000085 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150804 FILED AS OF DATE: 20150806 DATE AS OF CHANGE: 20150806 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: 411 E. WISCONSIN AVENUE STREET 2: SUITE 2100 CITY: MILWAUKEE STATE: WI ZIP: 53202 BUSINESS PHONE: 414-277-9445 MAIL ADDRESS: STREET 1: 411 E. WISCONSIN AVENUE STREET 2: SUITE 2100 CITY: MILWAUKEE STATE: WI ZIP: 53202 FORMER COMPANY: FORMER CONFORMED NAME: Quinpario Acquisition Corp. DATE OF NAME CHANGE: 20130613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cataldi David A. CENTRAL INDEX KEY: 0001611925 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36051 FILM NUMBER: 151033499 MAIL ADDRESS: STREET 1: C/O JASON INDUSTRIES STREET 2: 411 EAST WISCONSIN AVENUE, SUITE 2100 CITY: MILWAUKEE STATE: WI ZIP: 53202 4 1 wf-form4_143889274609693.xml FORM 4 X0306 4 2015-08-04 0 0001579252 Jason Industries, Inc. JASN 0001611925 Cataldi David A. 411 EAST WISCONSIN AVE. SUITE 2100 MILWAUKEE WI 53202 0 1 0 0 President, Acoustics segment Common Stock 2015-08-04 4 P 0 4500 5.6764 A 4500 I By David A Cataldi living trust dtd 10/24/2000 Revocable Trust Common Stock 10000 I By Annette M Cataldi living trust dtd 10/24/2000 Revocable Trust Common Stock 15839 D Restricted Stock Units Common Stock 46312.0 46312 D Restricted Stock Units Common Stock 81047.0 81047 D JPHI Holdings, Inc. common stock Common Stock 73063.0 73063 D The time-vesting restricted stock units vest in equal one-third (1/3) installments on each of the first three (3) anniversaries following June 30, 2014, provided that the reporting person has not been terminated prior to the applicable vesting date. Provided that the reporting person has not been terminated prior to the applicable vesting date, the stock-price vesting restricted stock units vest in the following amounts if on any date between June 30, 2014 and the third anniversary of that date the fair market value of Jason Industries, Inc.'s common stock: (i) equals or exceeds $12.00 in any twenty (20) trading days within a thirty (30) day period, then 20,261.75 of the stock price-vesting restricted stock units shall vest; (ii) equals or exceeds $13.50 in any twenty (20) trading days within a thirty (30) day period, then an additional 20,261.75 of the stock price-vesting restricted stock units shall vest (a total of 40,523.5 of the stock price-vesting restricted stock units); (Continued from footnote 2) (iii) equals or exceeds $15.00 in any twenty (20) trading days within a thirty (30) trading day period, then an additional 20,261.75 of the stock price-vesting restricted stock units shall vest (a total of 60,785.25 of the stock price-vesting restricted stock units); and (iv) equals or exceeds $17.00 in any twenty (20) trading days within a thirty (30) trading day period, then an additional 20,261.75 of the stock price-vesting restricted stock units shall vest (a total of 81,047 of the stock price-vesting restricted stock units). Any portion of the stock price-vesting restricted stock units that have not become fully vested on the date immediately following the third anniversary of June 30, 2014 shall be cancelled and forfeited for no consideration. Exchangeable on a one-share to one-share ratio (1:1) for common stock of Jason Industries, Inc., such ratio to be adjusted upon certain events, including stock splits, dividends and other changes to or payments on Jason Industries, Inc. common stock, pursuant to the terms of that certain Investor Rights Agreement, dated as of June 30, 2014, by and among each of Quinpario Acquisition Corp. (now known as Jason Industries, Inc.), JPHI Holdings, Inc. and each of the Holders signatory thereto. This filing corrects the reporting person's Table I ownership of the issuer's common stock to reflect that 10,000 shares of common stock, that had been previously reported as being owned directly on the reporting person's Form 4s filed on December 1, 2015 and July 1, 2015, are actually owned indirectly by a revocable trust. /s/ William P. Schultz as attorney-in-fact 2015-08-06