SEC Form 4 · accession 0001144204-16-136550
Xtant Medical Holdings, Inc. · XTNT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Daniel S Goldberger
Officer — Chief Executive Officer · Director
Period of report
Nov 14, 2016
Accepted (ET)
Nov 25, 2016 · 3:15 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001453593
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 17, 2016 | X | 120,000 | $0.75 | A | 135,510 | D | |
| Common Stock | holding | — | — | — | 86,522 | I | By IRA |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subscription Rights (right to receive)F1 | $0.75 | Nov 14, 2016 | X | 120,000 | D | Oct 31, 2016 | Nov 14, 2016 | See footnote | 120,000 | 0 | D |
| Warrants (right to buy)F1,F2 | $0.90 | Nov 17, 2016 | X | 120,000 | A | Nov 17, 2016 | Nov 17, 2021 | Common Stock | 120,000 | 120,000 | D |
Explanation of responses
- F1The common stock and the warrants reported on this Form 4 were acquired pursuant to the exercise of subscription rights previously distributed by the Issuer to all holders of the Issuer's common stock and outstanding convertible notes. Each holder received 2 subscription rights per share of stock owned, and each right allowed the recipient to purchase one unit, consisting of one share of common stock and one warrant to purchase one share of common stock. The subscription price per unit was $0.75.
- F2Each warrant entitles the holder to purchase one share of the Company's common stock at an exercise price of $0.90 from the date of issuance through November 17, 2021.