SEC Form 3 · accession 0001382963-15-000099
Xtant Medical Holdings, Inc. · XTNT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Brian J. Hemmelgarn
10% Owner
Period of report
Jul 31, 2015
Accepted (ET)
Aug 7, 2015 · 8:32 pm EDT
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,F2 | holding | — | — | — | 1,272,796 | I | By trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares are currently held in escrow and subject to forfeiture to satisfy claims arising under the Stock Purchase Agreement dated July 27, 2015 whereby Xtant Medical Holdings, Inc. (formerly known as Bacterin International Holdings, Inc.) acquired all of the capital stock of X-spine Systems, Inc.
- F2The shares are held by the Brian J. Hemmelgarn Revocable Living Trust dated February 9, 1998, as amended, which may be revoked by Mr. Hemmelgarn and of which Mr. Hemmelgarn is a beneficiary and the sole trustee.