0001144204-16-136550.txt : 20161125
0001144204-16-136550.hdr.sgml : 20161125
20161125151510
ACCESSION NUMBER: 0001144204-16-136550
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161114
FILED AS OF DATE: 20161125
DATE AS OF CHANGE: 20161125
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Xtant Medical 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: 664 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
BUSINESS PHONE: 406-388-0480
MAIL ADDRESS:
STREET 1: 664 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
FORMER COMPANY:
FORMER CONFORMED NAME: Bacterin International Holdings, Inc.
DATE OF NAME CHANGE: 20100615
FORMER COMPANY:
FORMER CONFORMED NAME: K KITZ INC
DATE OF NAME CHANGE: 20090108
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Goldberger Daniel S
CENTRAL INDEX KEY: 0001382042
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 162018252
MAIL ADDRESS:
STREET 1: 11400 W OLYMPIC BLVD
STREET 2: SUITE 200
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
4
1
v453905_4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-11-14
0
0001453593
Xtant Medical Holdings, Inc.
XTNT
0001382042
Goldberger Daniel S
664 CRUISER LANE
BELGRADE
MT
59714
1
1
0
0
Chief Executive Officer
Common Stock
2016-11-17
4
X
0
120000
0.75
A
135510
D
Common Stock
86522
I
By IRA
Subscription Rights (right to receive)
0.75
2016-11-14
4
X
0
120000
0
D
2016-10-31
2016-11-14
See footnote
120000
0
D
Warrants (right to buy)
0.90
2016-11-17
4
X
0
120000
A
2016-11-17
2021-11-17
Common Stock
120000
120000
D
The common stock and the warrants reported on this Form 4 were acquired pursuant to the exercise of subscription rights previously distributed by the Issuer to all holders of the Issuer's common stock and outstanding convertible notes. Each holder received 2 subscription rights per share of stock owned, and each right allowed the recipient to purchase one unit, consisting of one share of common stock and one warrant to purchase one share of common stock. The subscription price per unit was $0.75.
Each warrant entitles the holder to purchase one share of the Company's common stock at an exercise price of $0.90 from the date of issuance through November 17, 2021.
/s/ Daniel Goldberger
2016-11-25