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