0001209191-20-043577.txt : 20200724 0001209191-20-043577.hdr.sgml : 20200724 20200724143834 ACCESSION NUMBER: 0001209191-20-043577 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200722 FILED AS OF DATE: 20200724 DATE AS OF CHANGE: 20200724 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rich Terry M. CENTRAL INDEX KEY: 0001544482 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38832 FILM NUMBER: 201046707 MAIL ADDRESS: STREET 1: 520 LAKE COOK ROAD STREET 2: SUITE 315 CITY: DEERFIELD STATE: IL ZIP: 60015 FORMER NAME: FORMER CONFORMED NAME: Rich Terry DATE OF NAME CHANGE: 20120312 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SURGALIGN HOLDINGS, INC. CENTRAL INDEX KEY: 0001760173 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 832540607 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 520 LAKE COOK ROAD, SUITE 315 CITY: DEERFIELD STATE: IL ZIP: 60015 BUSINESS PHONE: 3864188888 MAIL ADDRESS: STREET 1: 520 LAKE COOK ROAD, SUITE 315 CITY: DEERFIELD STATE: IL ZIP: 60015 FORMER COMPANY: FORMER CONFORMED NAME: RTI Surgical Holdings, Inc. DATE OF NAME CHANGE: 20190308 FORMER COMPANY: FORMER CONFORMED NAME: Bears Holding Sub, Inc. DATE OF NAME CHANGE: 20181127 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-07-22 0 0001760173 SURGALIGN HOLDINGS, INC. RTIX 0001544482 Rich Terry M. 520 LAKE COOK ROAD, SUITE 315 DEERFIELD IL 60015 0 1 0 0 President and CEO Common Stock 2020-07-22 4 A 0 48093 0.00 A 292732 D Option to purchase common stock 3.14 2020-07-22 4 A 0 72140 0.00 A 2030-07-21 Common Stock 72140 439098 D The restricted shares will become vested as to 16,031 shares on 1/13/2021 and 4,008 shares on each of 4/13/2021, 7/13/2021, 10/13/2021, 1/13/2022 and 4/13/2022, 7/13/2022 and 4,007 shares on each of 10/13/2022 and 1/13/2023. The options will become exercisable as to 24,047 shares on 1/13/2021 and 6,012 shares on each of 4/13/2021, 7/13/2021, 10/13/2021, 1/13/2022 and 4/13/2022 and 6,011 shares on each of 7/13/2022, 10/13/2022 and 1/13/2023. By Jonathon Singer as attorney in fact 2020-07-24