0001144204-11-012930.txt : 20110304 0001144204-11-012930.hdr.sgml : 20110304 20110304154910 ACCESSION NUMBER: 0001144204-11-012930 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20110304 FILED AS OF DATE: 20110304 DATE AS OF CHANGE: 20110304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WICKWIRE JON M. CENTRAL INDEX KEY: 0001514546 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 11664591 MAIL ADDRESS: STREET 1: 600 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 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 3 1 v213537_ex.xml X0203 3 2011-03-04 0 0001453593 Bacterin International Holdings, Inc. BONE 0001514546 WICKWIRE JON M. 600 CRUISER LANE BELGRADE MT 59714 1 0 0 0 Common Stock 62500 D Common Stock 181198 I By Jon M Wickwire Trust Common Stock 13300 I By Matthew Wickwire Family Trust Common Stock 13299 I By Christian Wickwire Family Trust Common Stock 3800 I By adult child Common Stock 3800 I By adult child Warrant 1.16 2015-01-01 Common Stock 16509 D Warrant 2.50 2010-08-23 2015-08-23 Common Stock 11719 D Warrant 2.50 2010-09-29 2015-09-29 Common Stock 3906 D Warrant 2.00 2008-01-01 2012-12-03 Common Stock 18750 I By Jon M. Wickwire Trust Warrant Common Stock 1875 I By Jon M. Wickwire Trust Warrant 2.00 2009-02-18 2013-10-29 Common Stock 8333 I By Jon M. Wickwire Trust Warrant 2.00 2008-01-01 2012-12-03 Common Stock 1875 I By Jon M. Wickwire Trust Warrant 2.40 2009-11-17 2019-11-17 Common Stock 15000 I By Jon M. Wickwire Trust Warrant 2.00 2008-01-01 2012-12-31 Common Stock 3750 I By Matthew Wickwire Family Trust Warrant 2.00 2008-01-01 2012-12-31 Common Stock 1875 I By Christian Wickwire Family Trust The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for the purposes of Section 16 or for any other purpose. This warrant is currently exercisable, but the original date upon which this warrant became exercisable is unknown. Unknown Exhibit Index Exhibit 24 - Limited Power of Attorney /s/ Jon Wickwire 2011-03-04 EX-24 2 v213537_ex24.txt LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS Know all by these presents, that the undersigned hereby constitutes and appoints Jill Gilpin as the undersigned's true and lawful attorney-in-fact to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as a director and/or officer of Bacterin International Holdings, Inc. (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, and the rules thereunder; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the request of the undersigned, is not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934, as amended. This Limited Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney to be executed as of this 3rd day of March, 2011. /s/ Jon Wickwire _____________________________________ Name: Jon Wickwire _______________________________