0001104659-20-134246.txt : 20201210
0001104659-20-134246.hdr.sgml : 20201210
20201210165027
ACCESSION NUMBER: 0001104659-20-134246
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201209
FILED AS OF DATE: 20201210
DATE AS OF CHANGE: 20201210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jordan Maybelle
CENTRAL INDEX KEY: 0001826123
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39577
FILM NUMBER: 201381180
MAIL ADDRESS:
STREET 1: C/O AZIYO BIOLOGICS, INC.
STREET 2: 12510 PROSPERITY DRIVE, SUITE 370
CITY: SILVER SPRING
STATE: MD
ZIP: 20904
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: AZIYO BIOLOGICS, INC.
CENTRAL INDEX KEY: 0001708527
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 474790334
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 12510 PROSPERITY DRIVE
STREET 2: SUITE 370
CITY: SILVER SPRING
STATE: MD
ZIP: 20904
BUSINESS PHONE: 240-247-1143
MAIL ADDRESS:
STREET 1: 12510 PROSPERITY DRIVE
STREET 2: SUITE 370
CITY: SILVER SPRING
STATE: MD
ZIP: 20904
4
1
tm2038235-3_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2020-12-09
0
0001708527
AZIYO BIOLOGICS, INC.
AYZO
0001826123
Jordan Maybelle
C/O AZIYO BIOLOGICS, INC.
12510 PROSPERITY DRIVE, SUITE 370
SILVER SPRING
MD
20904
1
0
0
0
STOCK OPTION (RIGHT TO BUY)
17.00
2020-12-09
4
A
0
14307
0.00
A
2030-12-08
CLASS A COMMON STOCK
14307
14307
D
This option vests and becomes exercisable in three equal installments on each of October 8, 2021, 2022 and 2023.
/s/ Jeffrey Hamet, Attorney-in-Fact for Maybelle Jordan
2020-12-10