SD 1 insigniaformsd2017-05v2.htm FORM SD Blueprint
 
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
 
Washington, D.C. 20549
 
 
 
______________________
 
FORM SD
__________________
 
 
 
Specialized Disclosure Report
 
 
INSIGNIA SYSTEMS, INC.
(Exact name of registrant as specified in its charter)
 
 
 
 
Minnesota
 
1-13471

41-1656308
 (State or other jurisdiction of incorporation or organization)
 
(Commission File Number)

 
(IRS Employer identification No.)
 
 
 
 
 8799 Brooklyn Blvd., Minneapolis, Minnesota
  
55445
 (Address of principal executive offices)   
    
(Zip Code)
                                                                                                            
 
 
Kristine Glancy, President and CEO
763-392-6200
 (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 to December 31, 2016.
 

 
 
 
 
 
 
 
Section 1 - Conflict Minerals Disclosure
 
 
Item 1.01 Conflict Minerals Disclosure and Report
 
Conflict Minerals Disclosure
 
This Form SD of Insignia Systems, Inc. (the “Company”) is filed pursuant to Rule 13p-1 promulgated under the Securities and Exchange Act of 1934, as amended, for the reporting period January 1, 2016 to December 31, 2016.
 
A copy of the Company’s Conflict Minerals Report is provided as Exhibit 1.01 to this Form SD, and is publicly available at www.insigniasystems.com.
 
 
 
Item 1.02 Exhibit
 
 
As specified in Section 2, Item 2.01 of this Form SD, the Company is hereby filing its Conflict Minerals Report as Exhibit 1.01 to this report.
 
 
 
Section 2 – Exhibits
 
Item 2.01 Exhibits
 
The following exhibit is included herewith:
 
 
Exhibit Number
Description
 
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.
 
 
Insignia Systems, Inc.                              
(Registrant)
 
 
 
Date: May 25, 2017
 
 
By    /s/ Kristine A. Glancy
            Kristine A. Glancy
            President and Chief Executive Officer   
(on behalf of registrant)
 
 
 
 
 
 
EXHIBIT INDEX
 
 
Exhibit Number
Description
 
1.01
 
Conflict Minerals Report as required by Items 1.01 and 1.02 of this Form.