0001376339-17-000016.txt : 20170210 0001376339-17-000016.hdr.sgml : 20170210 20170210160603 ACCESSION NUMBER: 0001376339-17-000016 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161231 FILED AS OF DATE: 20170210 DATE AS OF CHANGE: 20170210 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MIMEDX GROUP, INC. CENTRAL INDEX KEY: 0001376339 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 900300868 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1775 W OAK COMMONS COURT, NE CITY: MARIETTA STATE: GA ZIP: 30062 BUSINESS PHONE: 678-384-6720 MAIL ADDRESS: STREET 1: 1775 W OAK COMMONS COURT, NE CITY: MARIETTA STATE: GA ZIP: 30062 FORMER COMPANY: FORMER CONFORMED NAME: Alynx, Co. DATE OF NAME CHANGE: 20060922 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hack Bruce CENTRAL INDEX KEY: 0001478931 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35887 FILM NUMBER: 17593262 MAIL ADDRESS: STREET 1: 151 CENTRAL PARK WEST STREET 2: APT 10C CITY: NEW YORK STATE: NY ZIP: 10023 5 1 wf-form5_148676074491399.xml FORM 5 X0306 5 2016-12-31 0 0 0 0001376339 MIMEDX GROUP, INC. MDXG 0001478931 Hack Bruce C/O MIMEDX GROUP, INC. 1775 WEST OAK COMMONS COURT, NE MARIETTA GA 30062 1 0 0 0 Common Stock 2016-07-01 5 G 0 269479 0 D 438096 D Common Stock 2016-07-01 5 G 0 269479 0 A 269479 I by GRAT This transaction involves a gift transfer to a Grantor Retained Annuity Trust of which the reporting person's spouse serves as trustee. /s/ Alexandra O. Haden, as power of attorney for Bruce Hack 2017-02-10