0001144204-16-111798.txt : 20160706
0001144204-16-111798.hdr.sgml : 20160706
20160706190603
ACCESSION NUMBER: 0001144204-16-111798
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160701
FILED AS OF DATE: 20160706
DATE AS OF CHANGE: 20160706
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: LOPACH MICHAEL A
CENTRAL INDEX KEY: 0001508142
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 161755178
MAIL ADDRESS:
STREET 1: 863 GREAT NORTHERN BLVD
STREET 2: SUITE 202
CITY: HELENA
STATE: MT
ZIP: 59601
4
1
v443749_4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-07-01
0
0001453593
Xtant Medical Holdings, Inc.
XTNT
0001508142
LOPACH MICHAEL A
664 CRUISER LANE
BELGRADE
MT
59714
1
0
0
0
Common Stock
2016-07-01
4
M
0
11764
0
A
23286
D
Common Stock
2016-07-05
4
A
0
20101
0
A
43387
D
Common Stock
14258
I
By 401(k) Plan
Restricted Stock Unit
2016-07-01
4
M
0
11764
0
D
CommonStock
11764
0
D
The common stock vests on July 5, 2017
Each restricted stock unit converted into one share of common stock effective July 1, 2016.
/s/ Michael A. Lopach
2016-07-05