0001209191-11-062649.txt : 20111221
0001209191-11-062649.hdr.sgml : 20111221
20111221201859
ACCESSION NUMBER: 0001209191-11-062649
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111219
FILED AS OF DATE: 20111221
DATE AS OF CHANGE: 20111221
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zaderej Karen L.
CENTRAL INDEX KEY: 0001530968
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-16159
FILM NUMBER: 111275640
MAIL ADDRESS:
STREET 1: AXOGEN INC.
STREET 2: 13859 PROGRESS BLVD, SUITE 100
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: 13859 PROGRESS BLVD.
STREET 2: SUITE 100
CITY: ALACHUA
STATE: FL
ZIP: 32615
BUSINESS PHONE: (386) 462-6817
MAIL ADDRESS:
STREET 1: 13859 PROGRESS BLVD.
STREET 2: SUITE 100
CITY: ALACHUA
STATE: FL
ZIP: 32615
FORMER COMPANY:
FORMER CONFORMED NAME: LECTEC CORP /MN/
DATE OF NAME CHANGE: 19920703
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2011-12-19
0
0000805928
AxoGen, Inc.
AXGN
0001530968
Zaderej Karen L.
C/O AXOGEN, INC.
13859 PROGRESS BOULEVARD, SUITE 100
ALACHUA
FL
32615
1
1
0
0
Chief Executive Officer
Common Stock
2011-12-19
4
M
0
3348
0.27
A
46397
D
Common Stock
2011-12-19
4
M
0
1398
0.27
A
47795
D
Common Stock
2011-12-19
4
M
0
16773
0.27
A
64568
D
Common Stock
2011-12-19
4
M
0
674
0.27
A
65242
D
Common Stock
2011-12-19
4
M
0
381
0.27
A
65623
D
Common Stock
2011-12-19
4
M
0
54167
0.27
A
119790
D
Employee Stock Option (right to buy)
0.27
2011-12-19
4
M
0
3348
0.00
D
2006-06-07
2016-06-07
Common Stock
3348
0
D
Employee Stock Option (right to buy)
0.27
2011-12-19
4
M
0
1398
0.00
D
2007-04-27
2017-04-27
common stock
1398
0
D
Employee Stock Option (right to buy)
0.27
2011-12-19
4
M
0
16773
0.00
D
2007-12-06
2017-12-06
common stock
16773
0
D
Employee Stock Option (right to buy)
0.27
2011-12-19
4
M
0
674
0.00
D
2007-12-06
2017-12-06
common stock
674
0
D
Employee Stock Option (right to buy)
0.27
2011-12-19
4
M
0
381
0.00
D
2008-11-18
2018-11-18
common stock
381
126
D
Employee Stock Option (right to buy)
0.27
2011-12-19
4
M
0
54167
0.00
D
2010-06-09
2020-06-09
common stock
54167
90000
D
Acquired through exercise of vested portion of stock options.
These options vest semi-annually over four years from the date of grant.
All remaining option shares unvested.
/s/ Karen Zaderej
2011-12-21