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