-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Hy4mp4oS/9zW19LKfNfnDGit4N9zzW7CVQMsWLkiQdnbAbhQA3dzk3dUSPrbvmZt tgHUwbKEL1jJ3tWBSd5/iA== 0001140361-10-000702.txt : 20100105 0001140361-10-000702.hdr.sgml : 20100105 20100105171510 ACCESSION NUMBER: 0001140361-10-000702 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20091231 FILED AS OF DATE: 20100105 DATE AS OF CHANGE: 20100105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PETIT PARKER H CENTRAL INDEX KEY: 0000901434 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52491 FILM NUMBER: 10508205 MAIL ADDRESS: STREET 1: 1850 PARKWAY PL CITY: MARIETTA STATE: GA ZIP: 30067 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MIMEDX GROUP, INC. CENTRAL INDEX KEY: 0001376339 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 900300868 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 811 E LIVINGSTON COURT STREET 2: SUITE B CITY: MARIETTA STATE: GA ZIP: 30076 BUSINESS PHONE: 678-384-6720 MAIL ADDRESS: STREET 1: 811 E LIVINGSTON COURT STREET 2: SUITE B CITY: MARIETTA STATE: GA ZIP: 30076 FORMER COMPANY: FORMER CONFORMED NAME: Alynx, Co. DATE OF NAME CHANGE: 20060922 4 1 doc1.xml FORM 4 X0303 4 2009-12-31 0 0001376339 MIMEDX GROUP, INC. MDXG.OB 0000901434 PETIT PARKER H 9815 HIGHWAY 98W, UNIT 930 MIRAMAR BEACH FL 32550 1 1 0 0 Chief Executive Officer Common Stock 2009-12-31 4 P 0 1666667 .60 A 1682222 D Common Stock 2009-12-31 4 P 0 100000 .60 A 100000 I By Parker H. Petit Grantor Trust Common Stock 2009-12-31 4 P 0 100000 .60 A 100000 I By Petit Investments, LP 5% Convertible Promissory Note .60 2009-12-31 4 C 0 500000 500000 D 2009-12-31 2009-12-31 Common Stock 833333 0 D Common Stock Warrants (Right to Buy) .60 2009-12-21 2012-09-22 Common Stock 0 1666667 D Common Stock Warrants (Right to Buy) 1.50 2009-12-31 4 P 0 833333 0 A 2010-01-01 2014-12-31 Common Stock 833333 833333 D Common Stock Warrants (Right to Buy) 1.50 2009-12-31 4 P 0 50000 0 A 2010-01-01 2014-12-31 Common Stock 50000 50000 I By Parker H. Petit Grantor Trust Common Stock Warrants (Right to Buy) 1.50 2009-12-31 4 P 0 50000 0 A 2010-01-01 2014-12-31 Common Stock 50000 50000 I By Petit Investments, LP The 5% Convertible Promissory Note was paid in entirety by the issuer on 12/31/09. As a result of the above transaction, in conjunction with the 5% Convertible Promissory Note, the holder was issued warrants to purchase common stock, computed by dividing the aggregate amount of advances under the note by the conversion price and multiplying the resultant quotient by two. The number of derivative securities beneficially owned following the reported transaction on 10/15/09 was incorrectly stated, the revised amount is now properly stated. Received one warrant for every two shares of common stock purchased at $.60 per share. The reporting person is the trustee of the Trust. 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 these securities for purposes of Section 16 or for any other purpose. Michael J. Culumber, by Power of Attorney 2010-01-05 EX-24 2 poa1.htm POWER OF ATTORNEY Unassociated Document

Securities and Exchange Commission
Judiciary Plaza
450 Fifth Street, N.W.
Washington, DC  20549
Power of Attorney

 
Re:
MiMedx Group, Inc.

Gentlemen:
 
Know all by these presents, that the undersigned hereby constitutes and appoints each of Michael J. Culumber, Roberta L. McCaw, G. Donald Johnson, and T. Clark Fitzgerald III, or either of them signing singly, and with full power of substitution, the undersigned's true and lawful attorney-in-fact to:
 
(1)           prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit to the U.S. Securities and Exchange Commission (the “SEC”) a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;
 
(2)           execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of MiMedx Group, Inc., (the “Company”), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;
 
(3)           do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and
 
(4)           take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.
 
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.  The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.
 
This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.
 
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 8 day of June, 2009.
 
 
 
By:
/s/Parker H. Petit
     
 
Name:
Parker H. Petit
 
 
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