0001610717-23-000376.txt : 20231205 0001610717-23-000376.hdr.sgml : 20231205 20231205213113 ACCESSION NUMBER: 0001610717-23-000376 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231021 FILED AS OF DATE: 20231205 DATE AS OF CHANGE: 20231205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DaCosta Albert CENTRAL INDEX KEY: 0001887925 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40902 FILM NUMBER: 231468306 MAIL ADDRESS: STREET 1: C/O PARAGON 28, INC. STREET 2: 14445 GRASSLANDS DRIVE CITY: ENGLEWOOD STATE: CO ZIP: 80112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Paragon 28, Inc. CENTRAL INDEX KEY: 0001531978 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 273170186 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14445 GRASSLANDS DRIVE CITY: ENGLEWOOD STATE: CO ZIP: 80112 BUSINESS PHONE: 720-912-1332 MAIL ADDRESS: STREET 1: 14445 GRASSLANDS DRIVE CITY: ENGLEWOOD STATE: CO ZIP: 80112 4 1 form4.xml X0508 4 2023-10-21 0001531978 Paragon 28, Inc. FNA 0001887925 DaCosta Albert C/O PARAGON 28, INC. 14445 GRASSLANDS DRIVE ENGLEWOOD CO 80112 true true true See Remarks false Common Stock 2023-10-21 4 F 0 20628 9.49 D 485882 D Common Stock 25000 I By Spouse Common Stock 5311110 I See footnote Common Stock 5000000 I See footnote Payment of tax liability by withholding securities incident to vesting of restricted stock units ("RSUs"). Includes RSUs. Includes the purchase of 30,500 shares of common stock by DaCosta Family Trust on November 10, 2023, as reported on Form 4 filed by Reporting Person on November 13, 2023. Shares are held by The DaCosta Family Trust, of which the Reporting Person is trustee. Shares are held by DaCosta Investment Company, LLC, of which the Reporting Person is a manager. President & Chief Executive Officer /s/ Robert McCormack, as Attorney-in-Fact for Albert DaCosta 2023-12-05