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