0001144204-16-111801.txt : 20160706
0001144204-16-111801.hdr.sgml : 20160706
20160706190716
ACCESSION NUMBER: 0001144204-16-111801
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: WICKWIRE JON M.
CENTRAL INDEX KEY: 0001514546
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 161755184
MAIL ADDRESS:
STREET 1: 600 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
4
1
v443751_4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-07-01
1
0001453593
Xtant Medical Holdings, Inc.
XTNT
0001514546
WICKWIRE JON M.
664 CRUISER LANE
BELGRADE
MT
59714
0
0
0
1
Former Director
Common Stock
2016-07-01
4
M
0
11764
0
A
43011
D
Common Stock
23103
I
By trust
Common Stock
1330
I
By trust
Common Stock
1329
I
By trust
Restricted Stock Unit
2016-07-01
4
M
0
11764
0
D
Common Stock
11764
0
D
Each restricted stock unit converted into one share of common stock effective July 1, 2016.
/s/ Jon M. Wickwire
2016-07-05