0000805928-21-000107.txt : 20210603
0000805928-21-000107.hdr.sgml : 20210603
20210603171158
ACCESSION NUMBER: 0000805928-21-000107
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210601
FILED AS OF DATE: 20210603
DATE AS OF CHANGE: 20210603
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Levine Alan M
CENTRAL INDEX KEY: 0001766833
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36046
FILM NUMBER: 21993475
MAIL ADDRESS:
STREET 1: C/O AXOGEN, INC.
STREET 2: 13631 PROGRESS BLVD. - SUITE 400
CITY: ALACHUA
STATE: FL
ZIP: 32615
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Axogen, Inc.
CENTRAL INDEX KEY: 0000805928
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 411301878
STATE OF INCORPORATION: MN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 13631 PROGRESS BLVD.
STREET 2: SUITE 400
CITY: ALACHUA
STATE: FL
ZIP: 32615
BUSINESS PHONE: (386) 462-6817
MAIL ADDRESS:
STREET 1: 13631 PROGRESS BLVD.
STREET 2: SUITE 400
CITY: ALACHUA
STATE: FL
ZIP: 32615
FORMER COMPANY:
FORMER CONFORMED NAME: AxoGen, Inc.
DATE OF NAME CHANGE: 20111004
FORMER COMPANY:
FORMER CONFORMED NAME: LECTEC CORP /MN/
DATE OF NAME CHANGE: 19920703
4
1
wf-form4_162275467679419.xml
FORM 4
X0306
4
2021-06-01
0
0000805928
Axogen, Inc.
AXGN
0001766833
Levine Alan M
13631 PROGRESS BLVD.
SUITE 400
ALACHUA
FL
32615
1
0
0
0
Common Stock
2021-06-01
4
M
0
6173
0
A
8764
D
Restricted Stock Units
2021-06-01
4
M
0
6173
0
D
Common Stock
6173.0
0
D
Stock Option (right to buy)
19.76
2021-06-01
4
A
0
6030
0
A
2031-06-01
Common Stock
6030.0
6030
D
Restricted Stock Units
2021-06-01
4
A
0
3036
0
A
Common Stock
3036.0
3036
D
Each restricted stock unit represents a contingent right to receive one share of Axogen, Inc. common stock.
This reflects the number of restricted stock units that became vested as of June 1, 2021.
Annual equity grant for service as Director on the Axogen, Inc. Board of Directors. The number of shares pursuant to the equity grant is based on a $120,000 valuation as of the grant date and vests on June 1, 2022, one year from the anniversary of the grant date. One-half of the annual equity grant value is in the form of non-qualified stock options and one-half of the annual equity grant value is in the form of restricted stock units.
/s/ Alan M. Levine
2021-06-03