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