0000904454-17-000191.txt : 20170214 0000904454-17-000191.hdr.sgml : 20170214 20170214210855 ACCESSION NUMBER: 0000904454-17-000191 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170126 FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 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: 600 HOPE PARKWAY SE CITY: LEESBURG STATE: VA ZIP: 20175 BUSINESS PHONE: 703-777-3155 MAIL ADDRESS: STREET 1: 600 HOPE PARKWAY SE CITY: LEESBURG STATE: VA ZIP: 20175 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: REGAN BRIAN THOMAS CENTRAL INDEX KEY: 0001556077 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612646 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STREET 2: SUITE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Donovan Michael CENTRAL INDEX KEY: 0001317659 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612647 MAIL ADDRESS: STREET 1: 320 PARK AVENUE, SUITE 2500 CITY: NEW YORK STATE: NY ZIP: 10022-6815 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lee Eric J. CENTRAL INDEX KEY: 0001413863 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612648 MAIL ADDRESS: STREET 1: 320 PARK AVENUE, SUITE #2500 CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Scully Thomas CENTRAL INDEX KEY: 0001414384 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612649 MAIL ADDRESS: STREET 1: 320 PARK AVENUE, SUITE # 2500 CITY: NEW YORK STATE: NM ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RATHER JONATHAN M CENTRAL INDEX KEY: 0001212994 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612650 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TRAYNOR SEAN CENTRAL INDEX KEY: 0001212999 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612651 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MACKESY D SCOTT CENTRAL INDEX KEY: 0001212997 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612652 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WCAS Capital Partners IV, L.P. CENTRAL INDEX KEY: 0001297673 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36443 FILM NUMBER: 17612653 BUSINESS ADDRESS: STREET 1: 320 PARK AVENUE, SUITE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: (212) 893-9500 MAIL ADDRESS: STREET 1: 320 PARK AVENUE, SUITE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2017-01-26 0001499807 K2M GROUP HOLDINGS, INC. KTWO 0001297673 WCAS Capital Partners IV, L.P. C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 0001212997 MACKESY D SCOTT C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 0001212999 TRAYNOR SEAN C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 1 0 1 0 0001212994 RATHER JONATHAN M C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 0001414384 Scully Thomas C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 0001413863 Lee Eric J. C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 0001317659 Donovan Michael C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 0001556077 REGAN BRIAN THOMAS C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 Common Stock 2017-01-26 4 S 0 57488 20.23 D 78849 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. Part 2 of 2 /s/ David Mintz, Attorney-in-Fact 2017-02-14