0000904454-17-000227.txt : 20170308
0000904454-17-000227.hdr.sgml : 20170308
20170308122411
ACCESSION NUMBER: 0000904454-17-000227
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170308
FILED AS OF DATE: 20170308
DATE AS OF CHANGE: 20170308
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: Solomon Christopher
CENTRAL INDEX KEY: 0001608207
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36443
FILM NUMBER: 17674474
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: 17674475
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: 17674476
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: 17674477
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE, SUITE #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: 17674478
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
2017-03-08
1
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
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 AND 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
0001608207
Solomon Christopher
C/O WELSH, CARSON, ANDERSON & STOWE
320 PARK AVENUE, SUITE 2500
NEW YORK
NY
10022
0
0
1
0
Common Stock
2017-03-08
4
J
0
78849
0
D
0
D
Distribution-in-kind of shares by the designated Reporting Person pro rata to its partners, including 784 shares to WCAS CP IV Associates LLC, the sole general partner of the designated Reporting Person. WCAS CP IV Associates LLC will further distribute such 784 shares to its members, including the Reporting Owners listed below.
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 WCAS CP IV Associates LLC, 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
2017-03-08