SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
WICKWIRE JON M.

(Last) (First) (Middle)
600 CRUISER LANE

(Street)
BELGRADE MT 59714

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/04/2011
3. Issuer Name and Ticker or Trading Symbol
Bacterin International Holdings, Inc. [ BONE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 62,500 D
Common Stock 181,198 I By Jon M Wickwire Trust
Common Stock 13,300 I By Matthew Wickwire Family Trust
Common Stock 13,299 I By Christian Wickwire Family Trust
Common Stock 3,800(1) I By adult child
Common Stock 3,800(1) I By adult child
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrant (2) 01/01/2015 Common Stock 16,509 $1.16 D
Warrant 08/23/2010 08/23/2015 Common Stock 11,719 $2.5 D
Warrant 09/29/2010 09/29/2015 Common Stock 3,906 $2.5 D
Warrant 01/01/2008 12/03/2012 Common Stock 18,750 $2 I By Jon M. Wickwire Trust
Warrant (3) (3) Common Stock 1,875 (3) I By Jon M. Wickwire Trust
Warrant 02/18/2009 10/29/2013 Common Stock 8,333 $2 I By Jon M. Wickwire Trust
Warrant 01/01/2008 12/03/2012 Common Stock 1,875 $2 I By Jon M. Wickwire Trust
Warrant 11/17/2009 11/17/2019 Common Stock 15,000 $2.4 I By Jon M. Wickwire Trust
Warrant 01/01/2008 12/31/2012 Common Stock 3,750 $2 I By Matthew Wickwire Family Trust
Warrant 01/01/2008 12/31/2012 Common Stock 1,875 $2 I By Christian Wickwire Family Trust
Explanation of Responses:
1. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for the purposes of Section 16 or for any other purpose.
2. This warrant is currently exercisable, but the original date upon which this warrant became exercisable is unknown.
3. Unknown
Remarks:
Exhibit Index Exhibit 24 - Limited Power of Attorney
/s/ Jon Wickwire 03/04/2011
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.