0001617669-22-000085.txt : 20221123
0001617669-22-000085.hdr.sgml : 20221123
20221123093325
ACCESSION NUMBER: 0001617669-22-000085
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221107
FILED AS OF DATE: 20221123
DATE AS OF CHANGE: 20221123
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: 221412596
MAIL ADDRESS:
STREET 1: 10 KINZEL LANE
CITY: WEST ORANGE
STATE: NJ
ZIP: 07052
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: 1231
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
4
1
wf-form4_166921399143992.xml
FORM 4
X0306
4
2022-11-07
0
0001617669
Unique Fabricating, Inc.
UFAB
0001621461
Baum Richard L Jr
C/O UNIQUE FABRICATING, INC.
800 STANDARD PARKWAY
AUBURN HILLS
MI
48326
1
0
0
0
Common Stock, $0.001 par value
2022-11-07
4
J
0
31539
0
A
368333
D
The shares of common stock were among the shares issued as a fee to the placement agent of the Company's debt offering completed on November 7, 2022 and were subsequently distributed to employees of the placement agent.
The number of shares issued to the placement agent was determined based on a per share price of $0.52.
/s/ Richard L. Baum, Jr
2022-11-22