<SEC-DOCUMENT>0001193125-21-167135.txt : 20210520
<SEC-HEADER>0001193125-21-167135.hdr.sgml : 20210520
<ACCEPTANCE-DATETIME>20210520061028
ACCESSION NUMBER:		0001193125-21-167135
CONFORMED SUBMISSION TYPE:	SD
PUBLIC DOCUMENT COUNT:		1
<RULE>
<RULE-NAME>13p-1
<ITEM>
<ITEM-NUMBER>1.01
<ITEM-PERIOD>20201231
</ITEM>
</RULE>
FILED AS OF DATE:		20210520
DATE AS OF CHANGE:		20210520

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			CHIPMOS TECHNOLOGIES INC
		CENTRAL INDEX KEY:			0001123134
		STANDARD INDUSTRIAL CLASSIFICATION:	SEMICONDUCTORS & RELATED DEVICES [3674]
		IRS NUMBER:				000000000
		STATE OF INCORPORATION:			F5
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		SD
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-37928
		FILM NUMBER:		21942285

	BUSINESS ADDRESS:	
		STREET 1:		NO. 1, R & D ROAD 1
		STREET 2:		HSINCHU SCIENCE PARK, HSINCHU
		CITY:			TAIWAN
		STATE:			F5
		ZIP:			00000
		BUSINESS PHONE:		866-3-5770055

	MAIL ADDRESS:	
		STREET 1:		NO. 1, R & D ROAD 1
		STREET 2:		HSINCHU SCIENCE PARK, HSINCHU
		CITY:			TAIWAN
		STATE:			F5
		ZIP:			00000
</SEC-HEADER>
<DOCUMENT>
<TYPE>SD
<SEQUENCE>1
<FILENAME>d181034dsd.htm
<DESCRIPTION>FORM SD
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<HTML><HEAD>
<TITLE>Form SD</TITLE>
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 <P STYLE="line-height:1.0pt;margin-top:0pt;margin-bottom:0pt;border-bottom:1px solid #000000">&nbsp;</P>
<P STYLE="line-height:3.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000">&nbsp;</P> <P STYLE="margin-top:4pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>UNITED STATES </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>SECURITIES AND EXCHANGE COMMISSION </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:12pt; font-family:Times New Roman" ALIGN="center"><B>Washington, D.C. 20549 </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>FORM SD
</B></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:12pt; font-family:Times New Roman" ALIGN="center"><B>Specialized Disclosure Report </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:24pt; font-family:Times New Roman" ALIGN="center"><B>&#21335;&#33538;&#31185;&#25216;&#32929;&#20221;&#26377;&#38480;&#20844;&#21496; </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Exact name of registrant as specified in its charter) </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:24pt; font-family:Times New Roman" ALIGN="center"><B>ChipMOS TECHNOLOGIES INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Translation of Registrant&#146;s Name into English) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD VALIGN="top" ALIGN="center"><B>Taiwan, Republic of China</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"><B>001-37928</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"><B>Not applicable</B></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(State or other jurisdiction of</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>incorporation or organization)</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(Commission</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>File Number)</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(IRS Employer</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Identification No.)</B></P></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>No.&nbsp;1, R&amp;D Road 1, Hsinchu Science Park, </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Hsinchu, Taiwan, Republic of China </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(Address of principal executive offices) (Zip Code) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Silvia Su
</B></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Vice President, Finance and Accounting Management Center </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Tel No: (886) 3 577 0055 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(Name and telephone number, including area code, of the person to contact in connection with this report.) </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center> <P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">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: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="4%" VALIGN="top" ALIGN="left">&#9746;</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Rule <FONT STYLE="white-space:nowrap">13p-1</FONT> under the Securities Exchange Act (17 CFR <FONT
STYLE="white-space:nowrap">240.13p-1)</FONT> for the reporting period from January&nbsp;1 to December&nbsp;31, 2020. </P></TD></TR></TABLE> <P STYLE="font-size:10pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<P STYLE="line-height:1.0pt;margin-top:0pt;margin-bottom:0pt;border-bottom:1px solid #000000">&nbsp;</P> <P STYLE="line-height:3.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000">&nbsp;</P>
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<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B>Item&nbsp;1.01</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B></B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">This Specialized Disclosure Report on Form SD of ChipMOS TECHNOLOGIES INC. (&#147;ChipMOS&#148; or the &#147;Company&#148;) for the calendar year ended
December&nbsp;31, 2020, is submitted to the Securities and Exchange Commission (&#147;SEC&#148;) pursuant to Rule <FONT STYLE="white-space:nowrap">13p-1</FONT> under the Securities Exchange Act of 1934, as amended. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Company Overview </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">ChipMOS TECHNOLOGIES INC.
(https://www.chipmos.com) is an industry leading provider of outsourced semiconductor assembly and test services. With advanced facilities in Hsinchu Science Park, Hsinchu Industrial Park and Southern Taiwan Science Park in Taiwan, ChipMOS provide
assembly and test services to a broad range of customers, including leading fabless semiconductor companies, integrated device manufacturers and independent semiconductor foundries. The Company is listed on the Taiwan Stock Exchange under Stock
Ticker 8150 and the Company&#146;s ADSs is listed on the NASDAQ under the symbol &#147;IMOS&#148;. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Conflict Minerals Disclosure </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As required by Form SD, ChipMOS has conducted a good-faith, reasonable country of origin inquiry (a&nbsp;&#147;RCOI&#148;) for the calendar year ended
December&nbsp;31, 2020, and has determined and concluded that necessary conflict minerals used in its business operations did not originate in the Democratic Republic of Congo (the &#147;DRC&#148;) or any adjoining country. ChipMOS is dedicated to
being a socially responsible and environmentally friendly, sustainable and rule-abiding organization. The Company confirms and declares that it will not use, neither will it support the use of, conflict minerals that are originated from the DRC or
an adjoining country. For the calendar year ended December&nbsp;31, 2020, the Company carried out its RCOI in three stages, as described below. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">During
the first stage, ChipMOS determined whether any conflict minerals were necessary to the functionality or production of products manufactured by (or contracted to be manufactured by) the Company. The SEC defines &#147;conflict minerals&#148; as
columbite-tantalite (coltan), cassiterite (also known as tinstone), gold, wolframite, or their derivatives, which are limited to tantalum, tin, and tungsten. ChipMOS has determined that gold (Au), tantalum (Ta), tungsten (W)&nbsp;and tin (Sn) are
necessary conflict minerals used in its business operations. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">In the second stage, ChipMOS obtained information from its suppliers of conflict minerals,
using the &#147;Conflict Minerals Reporting Template&#148; developed by the Responsible Business Alliance (RBA), regarding the types of minerals they supply and the name and location of each smelter used to process minerals supplied to the Company.
The &#147;Conflict Minerals Reporting Template&#148; also includes confirmation by the conflict minerals supplier that it has adopted procedures designed to ensure that any metals supplied to the Company are conflict-free. Based on the
Company&#146;s review of this information, the Company reasonably determined that all of its conflict minerals suppliers source conflict minerals completely from countries other than the DRC and adjoining countries to the DRC. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Finally, to ensure <FONT STYLE="white-space:nowrap">on-going</FONT> compliance, as the third stage of the Company&#146;s RCOI, the Company requests that all
suppliers immediately inform the Company of any change in their conflict-free mineral supplier status. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">In addition to the above, the Company has received
from all of its conflict minerals suppliers a &#147;Guarantee Letter of <FONT STYLE="white-space:nowrap">Non-Use</FONT> of Conflict Minerals&#148;, which certifies that all products and packaging supplied by the conflict minerals supplier do not
contain conflict minerals that are originated from the DRC or an adjoining country. Together, the letter and the &#147;Conflict Minerals Reporting Template&#148; provide information and transparency as to the source of conflict minerals that are
supplied to the Company. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The information made available in this Specialized Disclosure Report for the calendar year ended December&nbsp;31, 2020, is also
available on the Company&#146;s website (https://www.chipmos.com/english/csr/editor.aspx?CCID=40). </P>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>SIGNATURES </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">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. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD VALIGN="top">ChipMOS TECHNOLOGIES INC.</TD>
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<TD VALIGN="top">(Registrant)</TD>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Silvia Su</P></TD>
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<TD VALIGN="bottom">May&nbsp;20, 2021</TD></TR>
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<TD VALIGN="top">Name:&nbsp;&nbsp;Silvia Su</TD>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:2.50em; text-indent:-2.50em; font-size:10pt; font-family:Times New Roman">Title:&nbsp;&nbsp;&nbsp;&nbsp;Vice President</P>
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<P STYLE="margin-top:0pt; margin-bottom:1pt; margin-left:2.50em; text-indent:-2.50em; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&#8195;&#8194;&#8201;&#8201;&nbsp;&nbsp;&nbsp;Finance and Accounting Management Center</P></TD>
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