0001610717-24-000156.txt : 20240312 0001610717-24-000156.hdr.sgml : 20240312 20240312180008 ACCESSION NUMBER: 0001610717-24-000156 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240308 FILED AS OF DATE: 20240312 DATE AS OF CHANGE: 20240312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DaCosta Albert CENTRAL INDEX KEY: 0001887925 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40902 FILM NUMBER: 24743759 MAIL ADDRESS: STREET 1: C/O PARAGON 28, INC. STREET 2: 14445 GRASSLANDS DRIVE CITY: ENGLEWOOD STATE: CO ZIP: 80112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Paragon 28, Inc. CENTRAL INDEX KEY: 0001531978 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 273170186 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14445 GRASSLANDS DRIVE CITY: ENGLEWOOD STATE: CO ZIP: 80112 BUSINESS PHONE: 720-912-1332 MAIL ADDRESS: STREET 1: 14445 GRASSLANDS DRIVE CITY: ENGLEWOOD STATE: CO ZIP: 80112 4 1 form4.xml X0508 4 2024-03-08 0001531978 Paragon 28, Inc. FNA 0001887925 DaCosta Albert C/O PARAGON 28, INC. 14445 GRASSLANDS DRIVE ENGLEWOOD CO 80112 true true true See Remarks false Common Stock 2024-03-08 4 A 0 166924 0 A 643336 D Common Stock 25000 I By Spouse Common Stock 5311110 I See footnote Common Stock 5000000 I See footnote Constitute restricted stock units ("RSUs") for which the Reporting Person is entitled to receive one (1) share of Common Stock for each RSU upon vesting. 25% of the RSUs shall vest on each anniversary of March 8, 2024, subject to the Reporting Person's continued service to the Issuer. Includes 398,388 RSUs. Shares are held by The DaCosta Family Trust, of which the Reporting Person is trustee. Shares are held by DaCosta Investment Company, LLC, of which the Reporting Person is a manager. President & Chief Executive Officer /s/ Robert McCormack, as Attorney-in-Fact for Albert DaCosta 2024-03-12