0000904454-15-000476.txt : 20150713
0000904454-15-000476.hdr.sgml : 20150713
20150713200325
ACCESSION NUMBER: 0000904454-15-000476
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150713
FILED AS OF DATE: 20150713
DATE AS OF CHANGE: 20150713
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: K2M GROUP HOLDINGS, INC.
CENTRAL INDEX KEY: 0001499807
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 272977810
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 751 MILLER DRIVE SE
CITY: LEESBURG
STATE: VA
ZIP: 20175
BUSINESS PHONE: 703-777-3155
MAIL ADDRESS:
STREET 1: 751 MILLER DRIVE SE
CITY: LEESBURG
STATE: VA
ZIP: 20175
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Solomon Christopher
CENTRAL INDEX KEY: 0001608207
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986298
MAIL ADDRESS:
STREET 1: C/O WELSH CARSON ANDERSON & STOWE
STREET 2: 320 PARK AVENUE, SUITE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SWANI SANJAY
CENTRAL INDEX KEY: 0001212996
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986299
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Queally Paul B.
CENTRAL INDEX KEY: 0001212993
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986300
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
FORMER NAME:
FORMER CONFORMED NAME: QUAELLY PAUL B
DATE OF NAME CHANGE: 20030106
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ANDERSON BRUCE K
CENTRAL INDEX KEY: 0001212987
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986302
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WELSH PATRICK J
CENTRAL INDEX KEY: 0001212985
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986304
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Welsh, Carson, Anderson & Stowe XI, L.P.
CENTRAL INDEX KEY: 0001437914
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986305
BUSINESS ADDRESS:
STREET 1: C/O WELSH, CARSON, ANDERSON & STOWE
STREET 2: 320 PARK AVENUE, SUITE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 212-893-9500
MAIL ADDRESS:
STREET 1: C/O WELSH, CARSON, ANDERSON & STOWE
STREET 2: 320 PARK AVENUE, SUITE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CARSON RUSSELL L
CENTRAL INDEX KEY: 0001212986
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986303
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DENICOLA ANTHONY J
CENTRAL INDEX KEY: 0001212992
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 15986301
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2015-07-13
0001499807
K2M GROUP HOLDINGS, INC.
KTWO
0001437914
Welsh, Carson, Anderson & Stowe XI, L.P.
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001212985
WELSH PATRICK J
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001212986
CARSON RUSSELL L
C/O WELSH, CARSON, ANDERSON AND STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001212987
ANDERSON BRUCE K
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001212992
DENICOLA ANTHONY J
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001212993
Queally Paul B.
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001212996
SWANI SANJAY
C/O WELSH, CARSON, ANDERSON AND STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
0001608207
Solomon Christopher
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
Common Stock
2015-07-13
4
S
0
3115287
22.60
D
14195044
D
The securities reported as directly beneficially owned by the designated Reporting Person may be deemed to be indirectly beneficially owned by each of the Reporting Owners listed below, each of whom is a managing member of the sole general partner of the designated Reporting Person. Pursuant to Instruction 4(b)(iv) of Form 4, each such individual has elected to report as indirectly beneficially owned the entire number of securities owned by the designated Reporting Person, however each of them disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.
Each Reporting Owner listed below also indirectly beneficially owns 207,853 shares of Common Stock held by WCAS Capital Partners IV, L.P. Such individuals are managing members of the sole general partner of WCAS Capital Partners IV, L.P. Such individuals may also be deemed to indirectly beneficially own 47,837 shares of Common Stock held by WCAS XI Co-Investors LLC. Pursuant to Instruction 4(b)(iv) of Form 4, each such individual has elected to report as indirectly beneficially owned the entire number of securities owned by each such entity, however each of them disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.
Jonathan M. Rather also indirectly beneficially owns 11,622 shares of Common Stock held by WCAS Management Corp, of which he is the sole controlling shareholder. Pursuant to Instruction 4(b)(iv) of Form 4, Mr. Rather has elected to report as indirectly beneficially owned the entire number of securities owned by such entity, however he disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.
Paul B. Queally and Sean M. Traynor each also directly beneficially own 440 shares of Common Stock.
Part 1 of 2
/s/ David Mintz, Attorney-in-Fact
2015-07-13