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