0001235802-23-000067.txt : 20230615 0001235802-23-000067.hdr.sgml : 20230615 20230615161412 ACCESSION NUMBER: 0001235802-23-000067 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230615 FILED AS OF DATE: 20230615 DATE AS OF CHANGE: 20230615 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MITCHELL-KELLER LORI D CENTRAL INDEX KEY: 0001242852 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 231017496 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 X0407 4 2023-06-15 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001242852 MITCHELL-KELLER LORI D 664 CRUISER LANE BELGRADE MT 59714 1 0 0 0 0 Common Stock 2023-06-15 4 A 0 45782 0 A 45782 D These shares are subject to a restricted stock unit award granted under the Xtant Medical Holdings, Inc. Second Amended and Restated 2018 Equity Incentive Plan, (as amended from time to time), and vest and become issuable on June 15, 2024, conditioned upon the Reporting Person remaining a director of Xtant through the vesting date. /s/ Amy E. Culbert, attorney-in-fact 2023-06-15