0001209191-22-006835.txt : 20220203 0001209191-22-006835.hdr.sgml : 20220203 20220203164817 ACCESSION NUMBER: 0001209191-22-006835 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220201 FILED AS OF DATE: 20220203 DATE AS OF CHANGE: 20220203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Serbousek Jon Carl CENTRAL INDEX KEY: 0001536875 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19961 FILM NUMBER: 22589329 MAIL ADDRESS: STREET 1: C/O BIOMET, INC. STREET 2: P.O. BOX 587 CITY: WARSAW STATE: IN ZIP: 46581-0587 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Orthofix Medical Inc. CENTRAL INDEX KEY: 0000884624 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3451 PLANO PARKWAY CITY: LEWISVILLE STATE: TX ZIP: 75056 BUSINESS PHONE: 214-937-2000 MAIL ADDRESS: STREET 1: 3451 PLANO PARKWAY CITY: LEWISVILLE STATE: TX ZIP: 75056 FORMER COMPANY: FORMER CONFORMED NAME: ORTHOFIX INTERNATIONAL N V DATE OF NAME CHANGE: 19970708 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-02-01 0 0000884624 Orthofix Medical Inc. OFIX 0001536875 Serbousek Jon Carl 3451 PLANO PARKWAY LEWISVILLE TX 75056 1 1 0 0 CEO Common Stock 2022-02-01 4 A 0 81967 0.00 A 194779 D Performance Share Units 0.00 2022-02-01 4 A 0 81967 0.00 A Common Stock 81967 81967 D Represents time-based vesting restricted stock units that vest in 25% increments on the first, second, third and fourth anniversaries of the grant date, February 1, 2022. Represents performance-based vesting restricted stock units ("PSUs") that will settle as common stock on a one-for-one basis. Under the terms of the grant, the PSUs may vest based upon achieved product revenues for the 2023 fiscal year (the "Product Revenue Vesting Percentage"), as modified by a total shareholder return ("TSR") modifier (the "TSR Modifier"). The amount in the table above represents the target number of PSUs granted. The performance period of the grant is 2/1/22-1/31/25. The Product Revenue Vesting Percentage can be achieved within a range of 50% to 200% of target, based upon the level of recognized revenues. If the Product Revenue Vesting Percentage is achieved at or above the threshold level, it shall be multiplied by the TSR Modifier (ranging from 0.75 to 1.25), which shall be determined based on the Company's relative TSR during the performance period as compared to a specified peer group. /s/ Kimberley A. Elting, Chief Legal and Development Officer, by power of attorney 2022-02-03