0001617669-16-000039.txt : 20160223
0001617669-16-000039.hdr.sgml : 20160223
20160223160102
ACCESSION NUMBER: 0001617669-16-000039
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160223
FILED AS OF DATE: 20160223
DATE AS OF CHANGE: 20160223
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Unique Fabricating, Inc.
CENTRAL INDEX KEY: 0001617669
STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLE PARTS & ACCESSORIES [3714]
IRS NUMBER: 461846791
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1228
BUSINESS ADDRESS:
STREET 1: 800 STANDARD PARKWAY
CITY: AUBURN HILLS
STATE: MI
ZIP: 48326
BUSINESS PHONE: 248-853-2333
MAIL ADDRESS:
STREET 1: 800 STANDARD PARKWAY
CITY: AUBURN HILLS
STATE: MI
ZIP: 48326
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Baum Richard L Jr
CENTRAL INDEX KEY: 0001621461
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37480
FILM NUMBER: 161448302
MAIL ADDRESS:
STREET 1: 10 KINZEL LANE
CITY: WEST ORANGE
STATE: NJ
ZIP: 07052
4
1
wf-form4_145626123617079.xml
FORM 4
X0306
4
2016-02-23
0
0001617669
Unique Fabricating, Inc.
UFAB
0001621461
Baum Richard L Jr
800 STANDARD PARKWAY
AUBURN HILLS
MI
48326
1
0
0
0
Common Stock
2016-02-23
4
X
0
21993
3.33
A
265494
D
Warrant to Buy Common Stock
3.33
2016-02-23
4
X
0
21993
0
D
2013-12-18
2023-12-18
Common Stock
21993.0
0
D
Stock Option (Right to Buy)
12.5
2025-08-17
Common Stock
7500.0
7500
D
Includes 7,500 stock options (right to buy) that were granted on August 17, 2015.
The 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.
/s/ Richard L. Baum, Jr
2016-02-23