0000904454-17-000197.txt : 20170214
0000904454-17-000197.hdr.sgml : 20170214
20170214212324
ACCESSION NUMBER: 0000904454-17-000197
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: Sobol Edward P.
CENTRAL INDEX KEY: 0001680910
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 17612712
MAIL ADDRESS:
STREET 1: C/O WELSH, CARSON, ADNERSON & STOWE
STREET 2: 320 PARK AVENUE
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: 17612714
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE, SUITE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022-6815
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: 17612716
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: 17612717
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: 17612719
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: 17612720
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: REGAN BRIAN THOMAS
CENTRAL INDEX KEY: 0001556077
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 17612713
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: TRAYNOR SEAN
CENTRAL INDEX KEY: 0001212999
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 17612718
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
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: 17612715
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
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
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
0001680910
Sobol Edward P.
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
3926068
20.23
D
5384858
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 may also be deemed to indirectly beneficially own 18,147 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 WCAS XI Co-Investors LLC, 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.
Paul B. Queally and Sean M. Traynor each also directly beneficially own 4,439 shares of Common Stock.
Part 2 of 2
/s/ David Mintz, Attorney-in-Fact
2017-02-14