0001144204-11-065295.txt : 20111116
0001144204-11-065295.hdr.sgml : 20111116
20111116110857
ACCESSION NUMBER: 0001144204-11-065295
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111115
FILED AS OF DATE: 20111116
DATE AS OF CHANGE: 20111116
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Godfrey Mitchell T
CENTRAL INDEX KEY: 0001298377
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 111209097
MAIL ADDRESS:
STREET 1: P.O. BOX 10206
CITY: BOZEMAN
STATE: MT
ZIP: 59719
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Bacterin International 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: 600 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
BUSINESS PHONE: 406-388-0480
MAIL ADDRESS:
STREET 1: 600 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
FORMER COMPANY:
FORMER CONFORMED NAME: K KITZ INC
DATE OF NAME CHANGE: 20090108
4
1
v240929_4.xml
OWNERSHIP DOCUMENT
X0304
4
2011-11-15
0
0001453593
Bacterin International Holdings, Inc.
BONE
0001298377
Godfrey Mitchell T
600 CRUISER LANE
BELGRADE
MT
59714
1
0
0
0
Stock Option
2.95
2011-11-15
4
A
0
150000
0
A
2021-11-15
Common Stock
150000
150000
D
The option becomes exercisable in three equal annual installments beginning on the first anniversary of the date of grant
/s/ Mitchell Godfrey
2011-11-16