SEC Form 4 · accession 0001179110-17-008297
Axogen, Inc. · AXGN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark Stephen Gold
Director
Period of report
May 30, 2017
Accepted (ET)
Jun 1, 2017 · 1:51 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000805928
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | May 30, 2017 | M | 5,000 | $8.95 | A | 345,248 | D |
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 purchase) | $8.95 | May 30, 2017 | M | 5,000 | D | May 24, 2017 | Dec 29, 2026 | Common Stock | 5,000 | 0 | D |
Explanation of responses
- F1The shares of common stock for Dr. Gold include 202,761 shares held jointly by Dr. Gold and his wife, indirect ownership of 20,000 shares held by Dr. Gold's spouse and indirect ownership of 122,487 shares held by MJSK, Ltd., a decedent investment trust held by Dr. Gold's family.