0001209191-14-013039.txt : 20140221
0001209191-14-013039.hdr.sgml : 20140221
20140221160157
ACCESSION NUMBER: 0001209191-14-013039
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140219
FILED AS OF DATE: 20140221
DATE AS OF CHANGE: 20140221
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: AMEDICA Corp
CENTRAL INDEX KEY: 0001269026
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1885 WEST 2100 STREET
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84119
BUSINESS PHONE: 801-839-3516
MAIL ADDRESS:
STREET 1: 1885 WEST 2100 STREET
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84119
FORMER COMPANY:
FORMER CONFORMED NAME: AMEDICA CORP
DATE OF NAME CHANGE: 20031104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kipke Arthur Karl
CENTRAL INDEX KEY: 0001599635
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33624
FILM NUMBER: 14633558
MAIL ADDRESS:
STREET 1: C/O AMEDICA CORPORATION
STREET 2: 1885 WEST 2100 STREET SOUTH
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84119
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-02-19
0
0001269026
AMEDICA Corp
AMDA
0001599635
Kipke Arthur Karl
C/O HAMPSHIRE GROUP, LLC,
500 PLAZA ON THE LAKE, SUITE #103
AUSTIN
TX
78746
0
0
1
0
Common Stock
2014-02-19
4
C
0
16914
A
16914
I
By Hampshire Asset Managements, LLC
Common Stock
2014-02-19
4
C
0
115656
A
115656
I
By KM Healthcare Holdings
Common Stock
2014-02-19
4
C
0
25915
A
25915
I
By Hampshire Healthcare Partners
Common Stock
2014-02-19
4
C
0
1250000
A
1303347
I
By Hampshire Med Tech Partners, LP
Series D Preferred Stock
2014-02-19
4
C
0
335100
0.00
D
Common Stock
16914
0
I
By Hampshire Asset Managements, LLC
Series D Preferred Stock
2014-02-19
4
C
0
2290600
0.00
D
Common Stock
115656
0
I
By KM Healthcare Holdings
Series D-1 Preferred Stock
2014-02-19
4
C
0
181000
0.00
D
Common Stock
11828
0
I
By Hampshire Healthcare Partners
Series E Preferred Stock
2014-02-19
4
C
0
319542
0.00
D
Common Stock
14087
0
I
By Hampshire Healthcare Partners
Series F Preferred Stock
2014-02-19
4
C
0
5000000
0.00
D
Common Stock
1250000
0
I
By Hampshire Med Tech Partners, LP
Each share of Series D Convertible Preferred Stock converted into 1.3014 shares of the Issuer's Common Stock pursuant to the terms of the Certificate of Designation for Series D Convertible Preferred Stock of the Issuer and had no expiration date.
Each share of Series D-1 Convertible Preferred Stock converted into 1.6834 shares of the Issuer's Common Stock pursuant to the terms of the Certificate of Designation for Series D-1 Convertible Preferred Stock of the Issuer and had no expiration date.
Each share of Series E Convertible Preferred Stock converted into 1.1363 shares of the Issuer's Common Stock pursuant to the terms of the Certificate of Designation for Series E Convertible Preferred Stock of the Issuer and had no expiration date.
Each share of Series F Convertible Preferred Stock converted into 6.44370 shares of the Issuer's Common Stock pursuant to the terms of the Certificate of Designation for Series F Convertible Preferred Stock of the Issuer and had no expiration date.
Reflects a 1-for-25.7746 reverse split of the Issuer's common stock effected on February 11, 2014.
Shares held by Hampshire Asset Managements, LLC, of which the Reporting Person is the presdent. The Reporting Person disclaims beneficial ownership except to the extent of any pecuniary interest therein.
Shares held by KM Healthcare Holdings LP. The Reporting Person shares voting and dispositive power with the general partner of KM Healthcare Holdings LP. The Reporting Person disclaims beneficial ownership except to the extent of any pecuniary interest therein.
Shares held by Hampshire Healthcare Partners LP, of which the Reporting Person is the managing member of the general partner, Hampshire Special Opportunities, LLC. The Reporting Person disclaims beneficial ownership except to the extent of any pecuniary interest therein.
Shares held by Hampshire Med Tech Partners, LP, of which the Reporting Person is the managing member of the general partner, Hampshire Med Tech Partners GP, LLC. The Reporting Person disclaims beneficial ownership except to the extent of any pecuniary interest therein.
/s/Jonathan Ursprung
2014-02-21