Sec Form 4 Filing - Berra III Paul J. @ Jason Industries, Inc. - 2014-06-30

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Berra III Paul J.
2. Issuer Name and Ticker or Trading Symbol
Jason Industries, Inc. [ JASN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Former VP General Counsel, Sec
(Last) (First) (Middle)
12935 N. FORTY DRIVE, SUITE 201
3. Date of Earliest Transaction (MM/DD/YY)
06/30/2014
(Street)
ST. LOUIS, MO63141
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 25,000 ( 1 ) D
Common Stock 36,670 I See footnote ( 2 ) ( 3 ) ( 4 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants $ 12 ( 5 ) ( 5 ) Common Stock 10,000 10,000 I See footnote ( 3 ) ( 4 ) ( 5 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Berra III Paul J.
12935 N. FORTY DRIVE, SUITE 201
ST. LOUIS, MO63141
Former VP General Counsel, Sec
Signatures
/s/ Paul J. Berra III 07/10/2014
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The reported securities include 10,000 shares held in a trust account and 15,000 held in an IRA account.
( 2 )Reported securities were acquired pursuant to that certain Unit Subscription Agreement dated as of May 31, 2013 by and among Quinpario Partners I, LLC and the Issuer. Reporting person is the indirect owner of 10,000 placement units and 26,670 shares of common stock through his membership interest in Quinpario Partners I, LLC and does not have voting or dispositive control over such securities.
( 3 )The reported securities are included within 1,150,000 Units purchased by Quinpario Partners I, LLC for $10.00 per Unit. Each Unit consists of one share of common stock, par value $0.0001 per share ("Common Stock") and one warrant to purchase one share of Common Stock. Such shares and warrants, respectively, are identical to the shares of Common Stock and warrants, respectively, included in the units sold in the Issuer's initial public offering ("IPO"), except for those differences set forth in the Issuer's IPO prospectus filed with the Commission on August 9, 2013. Such shares and warrants, respectively, are also subject to certain transfer restrictions. Such warrants may be exercised for cash or on a cashless basis, and are not subject to being called for redemption.
( 4 )Reporting person disclaims beneficial ownership except to the extent of its pecuniary interest therein, and this report shall not be deemed an admission that such reporting person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
( 5 )Each warrant is exercisable to purchase one share of Common Stock at an exercise price of $12.00 during the period commencing on the later of (i) twelve (12) months from the date of the closing of the Issuer's initial public offering or (ii) 30 days following the consummation of the Company's initial business combination (the "Business Combination"), and expiring on the fifth anniversary of the consummation of the Issuer's Business Combination.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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