0001144204-16-127723.txt : 20161011 0001144204-16-127723.hdr.sgml : 20161011 20161011174903 ACCESSION NUMBER: 0001144204-16-127723 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161006 FILED AS OF DATE: 20161011 DATE AS OF CHANGE: 20161011 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: O'Connell Carl CENTRAL INDEX KEY: 0001568971 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 161932009 MAIL ADDRESS: STREET 1: 1375 KINGS HIGHWAY EAST STREET 2: SUITE 400 CITY: FAIRFIELD STATE: CT ZIP: 06824 4 1 v450396_4.xml OWNERSHIP DOCUMENT X0306 4 2016-10-06 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001568971 O'Connell Carl 11350 GLEN BIRNHAM ROAD EADS TN 38028 0 1 0 0 President Stock Option 1.11 2016-10-06 4 A 0 300000 0 A 2026-10-06 Common Stock 300000 300000 D The option vests as follows: 60,000 shares on October 6, 2017, and 15,000 shares each on January 6, 2018, April 6, 2018, July 6, 2018, October 6, 2018, January 6, 2019, April 6, 2019, July 6, 2019, October 6, 2019, January 6, 2020, April 6, 2020, July 6, 2020, October 6, 2020, January 6, 2021, April 6, 2021, July 6, 2021, and October 6, 2021. /s/ Carl D. O'Connell 2016-10-11