0001235802-22-000017.txt : 20220118 0001235802-22-000017.hdr.sgml : 20220118 20220118161243 ACCESSION NUMBER: 0001235802-22-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220115 FILED AS OF DATE: 20220118 DATE AS OF CHANGE: 20220118 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Neils Scott C CENTRAL INDEX KEY: 0001902610 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 22535311 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 2022-01-15 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001902610 Neils Scott C 664 CRUISER LANE BELGRADE MT 59714 0 1 0 0 Interim Chief Financial Office Common Stock, $0.000001 par value 2022-01-15 4 A 0 88983 0 A 167108 D Stock Option (right to buy) 0.648 2022-01-15 4 A 0 109164 0 A 2032-01-15 Common Stock 109164 109164 D These shares will vest and be issued with respect to 22,246 shares on each of January 15, 2023, January 15, 2024, and January 15, 2025 and with respect to 22,245 shares on January 15, 2026 pursuant to a restricted stock unit award granted under the Xtant Medical Holdings, Inc. Amended and Restated 2018 Equity Incentive Plan, conditioned upon the Reporting Person remaining an employee of Xtant through the vesting date. Includes 78,125 shares that will be issued over time subject to vesting pursuant to a restricted stock unit granted under the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan and 88,983 shares that will be issued over time subject to vesting pursuant to a restricted stock unit granted under the Xtant Medical Holdings, Inc. Amended and Restated 2018 Equity Incentive Plan. This option vests with respect to 27,291 shares on January 15, 2023 and with respect to the remaining 75% of such shares over the three-year period thereafter in 12 as nearly equal as possible quarterly installments, conditioned upon the Reporting Person remaining an employee of Xtant through the vesting date. /s/ Amy E. Culbert, attorney-in-fact 2022-01-18