0001144204-15-054138.txt : 20150909 0001144204-15-054138.hdr.sgml : 20150909 20150909084408 ACCESSION NUMBER: 0001144204-15-054138 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150904 FILED AS OF DATE: 20150909 DATE AS OF CHANGE: 20150909 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: WICKWIRE JON M. CENTRAL INDEX KEY: 0001514546 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 151098015 MAIL ADDRESS: STREET 1: 600 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 4 1 v419969_form4.xml OWNERSHIP DOCUMENT X0306 4 2015-09-04 0 0001453593 Xtant Medical Holdings, Inc. BONE 0001514546 WICKWIRE JON M. 600 CRUISER LANE BELGRADE MT 59714 1 0 0 0 Common Stock 2015-09-04 4 P 0 10869 3.68 A 31247 D Common Stock 23103 I By Trust Common Stock 1330 I By Trust Common Stock 1329 I By Trust /s/ Jon Wickwire 2015-09-08