0001144204-12-061966.txt : 20121114
0001144204-12-061966.hdr.sgml : 20121114
20121114093453
ACCESSION NUMBER: 0001144204-12-061966
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121112
FILED AS OF DATE: 20121114
DATE AS OF CHANGE: 20121114
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WICKWIRE JON M.
CENTRAL INDEX KEY: 0001514546
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 121201293
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
4
1
v328363_4.xml
OWNERSHIP DOCUMENT
X0306
4
2012-11-12
0
0001453593
Bacterin International Holdings, Inc.
BONE
0001514546
WICKWIRE JON M.
600 CRUISER LANE
BELGRADE
MT
59714
1
0
0
0
Stock Option
1.29
2012-11-12
4
A
0
30000
0
A
2012-11-12
2022-11-12
Common Stock
30000
30000
D
/s/ Jon Wickwire
2012-11-13