0001235802-19-000103.txt : 20190816 0001235802-19-000103.hdr.sgml : 20190816 20190816160946 ACCESSION NUMBER: 0001235802-19-000103 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190815 FILED AS OF DATE: 20190816 DATE AS OF CHANGE: 20190816 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JENSEN GREG CENTRAL INDEX KEY: 0001199647 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 191033567 MAIL ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xtant Medical Holdings, Inc. CENTRAL INDEX KEY: 0001453593 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 205313323 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 BUSINESS PHONE: 406-388-0480 MAIL ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 FORMER COMPANY: FORMER CONFORMED NAME: Bacterin International Holdings, Inc. DATE OF NAME CHANGE: 20100615 FORMER COMPANY: FORMER CONFORMED NAME: K KITZ INC DATE OF NAME CHANGE: 20090108 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2019-08-15 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001199647 JENSEN GREG 664 CRUISER LANE BELGRADE MT 59714 0 1 0 0 VP, Finance & CFO Common Stock, $0.000001 par value 2019-08-15 4 A 0 33898 0 A 33898 D Stock Option (right to buy) 2.76 2019-08-15 4 A 0 39063 0 A 2029-08-15 Common Stock 39063 39063 D These shares will vest and be issued with respect to 8,474 shares on each of August 15, 2020 and August 15, 2021 and with respect to 8,475 shares on each of August 15, 2022 and August 15, 2023 pursuant to a restricted stock unit granted under the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan. This option vests with respect to 9,765 shares on August 15, 2020 and with respect to 9,766 shares on each of August 15, 2021, August 15, 2022 and August 15, 2023, subject to such Reporting Person's continued employment with Xtant Medical Holdings, Inc. /s/ Amy Culbert, attorney-in-fact 2019-08-16