SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM SD
Specialized Disclosure Report
INTEVAC, INC.
(Exact name of Registrant as specified in its charter)
| State of Delaware | 0-26946 | 94-3125814 | ||
| (State or other jurisdiction of incorporation or organization) |
(Commission File Number) |
(IRS Employer Identification Number) |
3560 Bassett Street
Santa Clara, CA 95054
(Address of principal executive offices and zip code)
James Moniz
(408) 986-9888
(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, 2017 to December 31, 2017. |
| Section 1 | Conflict Minerals Disclosure |
| Item 1.01 | Conflict Minerals Disclosure and Report |
With respect to the reporting period from January 1, 2017 to December 31, 2017, Intevac Inc. (the “Company”) (i) has determined that “conflict minerals” (as defined in Section 1, Item 1.01(d)(3) for Form SD) are necessary to the functionality or production of products that the Company has manufactured and contracted to manufacture, (ii) has performed, in good faith, a reasonable country of origin inquiry (“RCOI”) regarding the minerals that is designed to determine whether any of the conflict minerals originated in the Democratic Republic of the Congo or any adjoining country, as defined by paragraph (d)(1) of Item 1.01 of the Form SD, or are from recycled or scrap sources, as defined by paragraph (d)(6) of Item 1.01 of the Form SD and (iii) based on its RCOI, the Company has performed due diligence procedures as described further in the Conflict Minerals Report filed as Exhibit 1.01 hereto.
| Item 1.02 | Exhibit |
Conflict Minerals Disclosure
In accordance with Rule 13p-1 promulgated under the Securities Exchange Act of 1934, as amended (“Rule 13p-1”), and this Specialized Disclosure Report on From SD (this “Form”), the Company has filed a Conflict Minerals Report, which is attached as Exhibit 1.01 to this Form. A copy of this Form and the Conflict Minerals Report are publically available at www.intevac.com.
| Section 2 | Exhibits |
| Item 2.01 | Exhibits |
| Exhibit Number |
Description | |
| Exhibit 1.01 | Conflict Minerals Report as required by Items 1.01 and 1.02 of this Form. | |
SIGNATURE
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.
| INTEVAC, INC. | ||||||
| Date: May 18, 2018 | /s/ JAMES MONIZ | |||||
| James Moniz | ||||||
| Executive Vice President, Finance and Administration, | ||||||
| Chief Financial Officer and Treasurer | ||||||
EXHIBIT INDEX
|
Exhibit |
Description | |
| Exhibit 1.01 | Conflict Minerals Report as required by Items 1.01 and 1.02 of this Form. | |