0001144204-16-111807.txt : 20160706 0001144204-16-111807.hdr.sgml : 20160706 20160706191045 ACCESSION NUMBER: 0001144204-16-111807 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160705 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: TIMKO ERIC BERNARD CENTRAL INDEX KEY: 0001678273 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 161755199 MAIL ADDRESS: STREET 1: 1045 BROWN ROAD SOUTH CITY: WAYZATA STATE: MN ZIP: 55391 4 1 v443770_4.xml OWNERSHIP DOCUMENT X0306 4 2016-07-05 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001678273 TIMKO ERIC BERNARD 1045 BROWN ROAD SOUTH WAYZATA MN 55391 1 0 0 0 Stock Option 1.99 2016-07-05 4 A 0 29700 0 A 2017-07-05 2027-07-05 Common Stock 29700 29700 D /s/ Eric B. Timko 2016-07-05