0001209191-21-031234.txt : 20210510
0001209191-21-031234.hdr.sgml : 20210510
20210510162218
ACCESSION NUMBER: 0001209191-21-031234
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210507
FILED AS OF DATE: 20210510
DATE AS OF CHANGE: 20210510
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DeRienzis Joshua H
CENTRAL INDEX KEY: 0001445552
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38832
FILM NUMBER: 21907541
MAIL ADDRESS:
STREET 1: 4345 SOUTHPOINT BLVD
CITY: JACKSONVILLE
STATE: FL
ZIP: 32216
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SURGALIGN HOLDINGS, INC.
CENTRAL INDEX KEY: 0001760173
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 832540607
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 520 LAKE COOK ROAD, SUITE 315
CITY: DEERFIELD
STATE: IL
ZIP: 60015
BUSINESS PHONE: 3864188888
MAIL ADDRESS:
STREET 1: 520 LAKE COOK ROAD, SUITE 315
CITY: DEERFIELD
STATE: IL
ZIP: 60015
FORMER COMPANY:
FORMER CONFORMED NAME: RTI Surgical Holdings, Inc.
DATE OF NAME CHANGE: 20190308
FORMER COMPANY:
FORMER CONFORMED NAME: Bears Holding Sub, Inc.
DATE OF NAME CHANGE: 20181127
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-05-07
0
0001760173
SURGALIGN HOLDINGS, INC.
SRGA
0001445552
DeRienzis Joshua H
520 LAKE COOK ROAD
SUITE 315
DEERFIELD
IL
60015
0
1
0
0
Chief Legal Officer
Common Stock
2021-05-07
4
A
0
104697
0.00
A
249404
D
Common Stock
2021-05-07
4
A
0
31611
0.00
A
281015
D
Common Stock
2021-05-07
4
A
0
16574
0.00
A
297589
D
The Restricted Stock Units will vest over three years with 1/3 of the shares vesting after year one and remaining 2/3 of the shares vesting prorated quarterly.
Represents a portion of the 2020 short-term incentive plan; vests on May 7, 2022.
Represents recoupment of lost wages during 2020; with 1/2 of the shares vesting after year one and remaining 1/2 of the shares after year two.
/s/ Joshua H. DeRienzis
2021-05-10