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