0001493152-17-008545.txt : 20170804
0001493152-17-008545.hdr.sgml : 20170804
20170804164153
ACCESSION NUMBER: 0001493152-17-008545
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170728
FILED AS OF DATE: 20170804
DATE AS OF CHANGE: 20170804
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bal Bhajanjit
CENTRAL INDEX KEY: 0001593834
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33624
FILM NUMBER: 171009144
MAIL ADDRESS:
STREET 1: C/O AMEDICA CORPORATION
STREET 2: 1885 WEST 1200 STREET
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84119
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
4
1
form4.xml
X0306
4
2017-07-28
0
0001269026
AMEDICA Corp
AMDA
0001593834
Bal Bhajanjit
C/O AMEDICA CORPORATION
1885 W 2100 S
SALT LAKE CITY,
UT
84119
1
1
0
0
CEO
Warrant
0.42
2017-07-28
4
A
0
660000
0.00
A
2017-07-28
2022-07-28
Common
660000
660000
I
See Note
Warrant held by North Stadium Investments, LLC, an entity owned and controlled by the reporting person.
/s/ Kevin Ontiveros, Power of Attorney
2017-08-04