Specialized Disclosure Report (sd)
June 15 2016 - 4:23PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form SD
SPECIALIZED DISCLOSURE REPORT
Alexza
Pharmaceuticals, Inc.
(Exact Name of Registrant as Specified in Charter)
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DELAWARE
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000-51820
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77-0567768
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(State or Other Jurisdiction of
Incorporation)
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(Commission File Number)
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(IRS Employer Identification
Number)
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2091 Stierlin Court
Mountain View, CA
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94043
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(Address of Principal Executive Offices)
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(Zip Code)
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Thomas B. King
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(650)944-7000
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(Name and telephone number, including area code, of the person to contact
in connection with this report.)
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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:
x
Rule 13p-1 under the Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from
January 1 to December 31, 2015.
Section 1Conflict Minerals Disclosure
Item 1.01 Conflict Minerals Disclosure and Report
a)
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Conflict Minerals in Products.
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Conflict minerals, as defined by paragraph (d)(3) of this item, are
necessary to the functionality or productions of a product manufactured by Alexza Pharmaceuticals, Inc. (referred to as we, us, or the Company) or contracted by the Company to be manufactured (the
Companys Products) as defined in Rule 13p-1 under the Securities Exchange Act of 1934, as amended (the Rule) and for which manufacturing was completed in the period from January 1, 2015 to December 31, 2015.
Accordingly, we are filing this Form SD for the calendar year covered by this report, as required by the Rule.
b)
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Implementation and Results of our Reasonable Country of Origin Inquiry.
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We evaluated our current
product lines and determined that certain product we manufacture or contract to manufacture contain tin, tungsten, tantalum and/or gold (3TG). We requested our manufacturers to complete a Reasonable County of Origin (RCOI) questionnaire
for each such conflict mineral. The survey of our suppliers determined that our supply chain is Conflict Free Undeterminable and as a result we have filed a Conflict Minerals Report.
We recognize that the supply chain tracing of these materials is complex; however, we are committed to working with our suppliers to determine whether the
products we manufacture or contract to manufacture are conflict free, that is, that they either do not contain conflict minerals from the Covered Countries or originate from recycled or scrap materials.
A copy of The Companys Conflict Minerals Report is provided as Exhibit 1.01 hereto and is publicly available at: www.alexza.com under Corporate
Governance.
Item 1.02 Exhibit
The
Conflict Minerals Report required by Item 1.01 is filed as Exhibit 1.01 to this Form SD.
Section 2Exhibits
Item 2.01 Exhibits
Exhibit 1.01Conflict
Minerals Report for Alexza Pharmaceuticals, Inc.
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.
Alexza Pharmaceuticals, Inc.
(Registrant)
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/s/ Thomas B. King
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Thomas B. King
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President and Chief Executive Officer
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June 15, 2016
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