X0303 4 2009-12-31 0 0001376339 MIMEDX GROUP, INC. MDXG.OB 0000901434 PETIT PARKER H 9815 HIGHWAY 98W, UNIT 930 MIRAMAR BEACH FL 32550 1 1 0 0 Chief Executive Officer Common Stock 2009-12-31 4 P 0 1666667 .60 A 1682222 D Common Stock 2009-12-31 4 P 0 100000 .60 A 100000 I By Parker H. Petit Grantor Trust Common Stock 2009-12-31 4 P 0 100000 .60 A 100000 I By Petit Investments, LP 5% Convertible Promissory Note .60 2009-12-31 4 C 0 500000 500000 D 2009-12-31 2009-12-31 Common Stock 833333 0 D Common Stock Warrants (Right to Buy) .60 2009-12-21 2012-09-22 Common Stock 0 1666667 D Common Stock Warrants (Right to Buy) 1.50 2009-12-31 4 P 0 833333 0 A 2010-01-01 2014-12-31 Common Stock 833333 833333 D Common Stock Warrants (Right to Buy) 1.50 2009-12-31 4 P 0 50000 0 A 2010-01-01 2014-12-31 Common Stock 50000 50000 I By Parker H. Petit Grantor Trust Common Stock Warrants (Right to Buy) 1.50 2009-12-31 4 P 0 50000 0 A 2010-01-01 2014-12-31 Common Stock 50000 50000 I By Petit Investments, LP The 5% Convertible Promissory Note was paid in entirety by the issuer on 12/31/09. As a result of the above transaction, in conjunction with the 5% Convertible Promissory Note, the holder was issued warrants to purchase common stock, computed by dividing the aggregate amount of advances under the note by the conversion price and multiplying the resultant quotient by two. The number of derivative securities beneficially owned following the reported transaction on 10/15/09 was incorrectly stated, the revised amount is now properly stated. Received one warrant for every two shares of common stock purchased at $.60 per share. The reporting person is the trustee of the Trust. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. Michael J. Culumber, by Power of Attorney 2010-01-05