SEC Form 4 · accession 0001499807-16-000205
K2M GROUP HOLDINGS, INC. · KTWO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Carlos A Ferrer
Director
Period of report
Jun 14, 2016
Accepted (ET)
Jun 16, 2016 · 7:04 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001499807
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jun 14, 2016 | A | 3,999 | $0.00 | A | 63,381 | D | |
| Common StockF1,F2 | holding | — | — | — | 1,583,941 | I | See footnotes | |
| Common StockF2,F3 | holding | — | — | — | 57,796 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F5 | $14.38 | Jun 14, 2016 | A | 10,268 | A | — | Jun 14, 2026 | Common Stock | 10,268 | 10,268 | D |
Explanation of responses
- F1Represents securities held directly by FFC Partners III-B, L.P. ("FFC III-B").
- F2FFC GP III, LLC is the general partner of each of FFC III-B and FFC Executive Partners III, L.P. ("FFC EP III", and together with FFC III-B and FFC GP III, LLC, the "FFC Entities"). Carlos A. Ferrer, a member of the issuer's board of directors, is a manager of FFC GP III, LLC. Mr. Ferrer disclaims beneficial ownership of all securities held by the FFC Entities, except to the extent of his pecuniary interest therein, if any.
- F3Represents securities held directly by FFC EP III.
- F4Reflects a grant of restricted stock which vests in three equal installments on August 15, 2017, August 15, 2018, and August 15, 2019.
- F5An option which vests in three equal installments on August 15, 2017, August 15, 2018 and August 15, 2019.