SEC Form 4 · accession 0001179110-17-013746
Axogen, Inc. · AXGN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jamie Mark Grooms
Director
Period of report
Nov 1, 2017
Accepted (ET)
Nov 3, 2017 · 4:56 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,F2 | Nov 1, 2017 | M | 14,379 | $0.27 | A | 365,796 | D | |
| Common StockF1,F2 | Nov 1, 2017 | F | 189 | $20.60 | D | 365,607 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Director Stock Option (right to purchase) | $0.27 | Nov 1, 2017 | M | 11,182 | D | Dec 5, 2007 | Dec 5, 2017 | Common Stock | 11,182 | 0 | D |
| Director Stock Option (right to purchase) | $0.27 | Nov 1, 2017 | M | 3,197 | D | Dec 5, 2007 | Dec 5, 2017 | Common Stock | 3,197 | 0 | D |
Explanation of responses
- F1This Form is being filed to report the exercise of a stock option for a total of 14,397 shares by means of a cashless exercise. A cashless exercise is a method of exercising a stock option in which the option holder pays the exercise price using shares the reporting person would have received pursuant to the option exercise. As a result of this cashless exercise, the Reporting Person, on a net basis, acquired ownership of an additional 14,190 shares of common stock.
- F2These shares of common stock include 132,883 shares held by the Jamie Grooms Trust, of which Mr. Grooms is the trustee.