UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
FORM SD
SPECIALIZED DISCLOSURE REPORT
Jason Industries, Inc.
(Exact name of registrant as specified in its charter)
|
| | | | |
| Delaware | | 001-36051 | | 46-2888322 |
| (State or other | | (Commission | | (IRS Employer |
| jurisdiction of | | File Number) | | Identification No.) |
| incorporation | | | | |
| or organization) | | | | |
|
| | |
| 833 East Michigan Street, Suite 900 | | 53202 |
| Milwaukee, Wisconsin | | (Zip Code) |
| Address of Principal executive offices) | | |
Thomas L. Doerr, Jr.
Vice President, General Counsel and Secretary
(414) 277-9300
(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:
þ 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
A copy of Jason Industries, Inc.’s (the “Company”) Conflict Minerals Report for the reporting period from January 1 to December 31, 2016, is provided as Exhibit 1.01 hereto and is publicly available on the Company’s website at http://investors.jasoninc.com/sec-filings.aspx.
See Item 2.01 of this Form.
Section 2 – Exhibits
Exhibit 1.01 – Conflict Minerals Report of Jason Industries, Inc., as required by Items 1.01 and 1.02 of this Specialized Disclosure Report on Form SD.
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 undersigned hereunto duly authorized.
JASON INDUSTRIES, INC.
By: /s/ Thomas L. Doerr, Jr.
Name: Thomas L. Doerr, Jr.
| |
| Title: | Vice President, General Counsel and Secretary |
Date: April 13, 2017
