0001235802-19-000121.txt : 20190925
0001235802-19-000121.hdr.sgml : 20190925
20190925162946
ACCESSION NUMBER: 0001235802-19-000121
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190924
FILED AS OF DATE: 20190925
DATE AS OF CHANGE: 20190925
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Peters Jeffrey J
CENTRAL INDEX KEY: 0001329814
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 191114522
MAIL ADDRESS:
STREET 1: C/O EV3 INC.
STREET 2: 4600 NATHAN LANE NORTH
CITY: PLYMOUTH
STATE: MN
ZIP: 55442
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
2019-09-24
0
0001453593
Xtant Medical Holdings, Inc.
XTNT
0001329814
Peters Jeffrey J
664 CRUISER LANE
BELGRADE
MT
59714
1
0
0
0
Common Stock, $0.000001 par value
2019-09-24
4
A
0
5555
0
A
31597
D
These shares are subject to a restricted stock unit award granted under the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan and will vest and become issuable on February 15, 2020, conditioned upon the reporting person remaining a director of Xtant through the vesting date.
Includes 5,555 shares to be issued upon vesting pursuant to restricted stock unit award granted under the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan, conditioned upon the reporting person remaining a director of Xtant through the vesting date, and 13,021 shares issued as part of a restricted stock award granted under the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan, which shares are subject to forfeiture until vested.
/s/ Amy Culbert, attorney-in-fact
2019-09-25