0000899243-21-017486.txt : 20210429
0000899243-21-017486.hdr.sgml : 20210429
20210429212023
ACCESSION NUMBER: 0000899243-21-017486
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210427
FILED AS OF DATE: 20210429
DATE AS OF CHANGE: 20210429
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Treace John T.
CENTRAL INDEX KEY: 0001856380
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40355
FILM NUMBER: 21873326
MAIL ADDRESS:
STREET 1: C/O TREACE MEDICAL CONCEPTS, INC.
STREET 2: 203 FORT WADE ROAD, SUITE 150
CITY: PONTE VEDRA
STATE: FL
ZIP: 32081
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: TREACE MEDICAL CONCEPTS, INC.
CENTRAL INDEX KEY: 0001630627
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 471052611
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 203 FORT WADE ROAD
STREET 2: SUITE 150
CITY: PONTE VEDRA
STATE: FL
ZIP: 32081
BUSINESS PHONE: (904) 373-5940
MAIL ADDRESS:
STREET 1: 203 FORT WADE ROAD
STREET 2: SUITE 150
CITY: PONTE VEDRA
STATE: FL
ZIP: 32081
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-04-27
0
0001630627
TREACE MEDICAL CONCEPTS, INC.
TMCI
0001856380
Treace John T.
C/O TREACE MEDICAL CONCEPTS, INC.
203 FORT WADE RD., SUITE 150
PONTE VEDRA
FL
32081
1
1
1
0
Chief Executive Officer
Common Stock
2021-04-27
4
C
0
299510
A
11171385
D
Common Stock
2021-04-27
4
S
0
5253805
17.00
D
5917580
D
Common Stock
1605000
I
By Wife
Common Stock
1471250
I
By Wife as co-trustee of the JTT Irrevocable Trust dated September 30, 2020
Common Stock
1839063
I
As Trustee of the Tracy W. Treace Irrevocable Trust dated September 25, 2020
Series A Preferred Stock
2021-04-27
4
J
0
6932
0.00
A
Common Stock
6932
299510
D
Series A Preferred Stock
2021-04-27
4
C
0
299510
0.00
D
Common Stock
299510
0
D
Each share of the Issuer's Series A Preferred Stock automatically converted into one (1) share of the Issuer's Common Stock immediately upon the closing of the Issuer's initial public offering. The shares had no expiration date.
These shares were sold by the Reporting Person as a selling stockholder in conjuction with the Issuer's Form S-1 filing, Registration Number 333-254863. The offering closed on April 27, 2021. The reported sale price reflects the price at which the Reporting Person sold shares to the underwriters.
The Reporting Person disclaims beneficial ownership of shares held by his wife directly or in trusts for which his wife serves as trustee or co-trustee.
The Reporting Person received Series A Preferred Stock as a payment-in-kind dividend.
/s/ Jaime A. Frias as Attorney-in-fact for John T. Treace
2021-04-29