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