0001144204-16-111802.txt : 20160706 0001144204-16-111802.hdr.sgml : 20160706 20160706190755 ACCESSION NUMBER: 0001144204-16-111802 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160705 FILED AS OF DATE: 20160706 DATE AS OF CHANGE: 20160706 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xtant Medical Holdings, Inc. CENTRAL INDEX KEY: 0001453593 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 205313323 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 BUSINESS PHONE: 406-388-0480 MAIL ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 FORMER COMPANY: FORMER CONFORMED NAME: Bacterin International Holdings, Inc. DATE OF NAME CHANGE: 20100615 FORMER COMPANY: FORMER CONFORMED NAME: K KITZ INC DATE OF NAME CHANGE: 20090108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BUCKMAN PAUL CENTRAL INDEX KEY: 0001215243 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 161755186 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW RD CITY: EDEN PRAIRIE STATE: MN ZIP: 55402 4 1 v443756_4.xml OWNERSHIP DOCUMENT X0306 4 2016-07-05 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001215243 BUCKMAN PAUL 200 WILDHURST ROAD TONKA BAY MN 55331 1 0 0 0 Common Stock 2016-07-05 4 A 0 20101 0 A 20101 D The common stock vests on July 5, 2017. /s/ Paul R. Buckman 2016-07-05