0001579252-16-000184.txt : 20160705 0001579252-16-000184.hdr.sgml : 20160705 20160705183456 ACCESSION NUMBER: 0001579252-16-000184 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160630 FILED AS OF DATE: 20160705 DATE AS OF CHANGE: 20160705 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jason Industries, Inc. CENTRAL INDEX KEY: 0001579252 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS MANUFACTURING INDUSTRIES [3990] IRS NUMBER: 462888322 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 411 E. WISCONSIN AVENUE STREET 2: SUITE 2100 CITY: MILWAUKEE STATE: WI ZIP: 53202 BUSINESS PHONE: 414-277-9445 MAIL ADDRESS: STREET 1: 411 E. WISCONSIN AVENUE STREET 2: SUITE 2100 CITY: MILWAUKEE STATE: WI ZIP: 53202 FORMER COMPANY: FORMER CONFORMED NAME: Quinpario Acquisition Corp. DATE OF NAME CHANGE: 20130613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Doerr Thomas L Jr CENTRAL INDEX KEY: 0001658147 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36051 FILM NUMBER: 161751999 MAIL ADDRESS: STREET 1: 411 EAST WISCONSIN AVENUE STREET 2: SUITE 2100 CITY: MILWAUKEE STATE: WI ZIP: 53202 4 1 wf-form4_146775808288024.xml FORM 4 X0306 4 2016-06-30 0 0001579252 Jason Industries, Inc. JASN 0001658147 Doerr Thomas L Jr 833 EAST MICHIGAN STREET SUITE 900 MILWAUKEE WI 53202 0 1 0 0 VP, GC and Secretary Common Stock 2016-06-30 4 M 0 14588.50 0 A 14588.50 D Common Stock 2016-06-30 4 F 0 4974.50 3.61 D 9614 D Restricted Stock Units 2016-06-30 4 M 0 14588.50 0 D Common Stock 14588.5 14588.50 D Restricted Stock Units Common Stock 34040.0 34040 D The time-vesting restricted stock units vest in two equal installments with the first vesting date being June 30, 2016 and the second vesting date being June 30, 2017, provided that the reporting person has not been terminated prior to the applicable vesting date. Provided that the reporting person has not been terminated prior to the applicable vesting date, the stock-price vesting restricted stock units vest in the following amounts if on any date between November 9, 2015 and June 30, 2017 the fair market value of Jason Industries, Inc.'s common stock: (i) equals or exceeds $12.00 in any twenty (20) trading days within a thirty (30) day period, then 8,510 of the stock price-vesting restricted stock units shall vest; (ii) equals or exceeds $13.50 in any twenty (20) trading days within a thirty (30) day period, then an additional 8,510 of the stock price-vesting restricted stock units shall vest (a total of 17,020 of the stock price-vesting restricted stock units); (Continued from footnote 2) (iii) equals or exceeds $15.00 in any twenty (20) trading days within a thirty (30) trading day period, then an additional 8,510 of the stock price-vesting restricted stock units shall vest (a total of 25,530 of the stock price-vesting restricted stock units); and (iv) equals or exceeds $17.00 in any twenty (20) trading days within a thirty (30) trading day period, then an additional 8,510 of the stock price-vesting restricted stock units shall vest (a total of 34,040 of the stock price-vesting restricted stock units). Any portion of the stock price-vesting restricted stock units that have not become fully vested on or prior to June 30, 2017 shall be cancelled and forfeited for no consideration. /s/ Thomas L. Doerr, Jr. 2016-07-01