|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
|
| |||||||||||||||||||||||||||||
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
NQ Stock Option | $ 2.05 | 12/19/2012 | A | 200,000 (1) (2) | 12/19/2013(3) | 12/19/2019 | Common Stock | 200,000 | $ 2.05 (4) | 200,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Ryan Patrick C/O ALPHATEC SPINE, INC. 5818 EL CAMINO REAL CARLSBAD, CA, CA 92008 |
COO and President, Int'l. |
/s/ Ebun S. Garner, Esq., Attorney-in-fact | 06/12/2013 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | This option grant was made after the holder agreed to forfeit options granted to him on April 11, 2011. This transaction is described iun greater detail in a Schedule TO that the issuer filed with the SEC on December 19, 2012. |
(2) | Represents the uncancelled portion of the 250,000 options that were granted to the holder on December 19, 2013. |
(3) | The options vest over three years with one third vesting on the anniversary of the date of the grant and the remaining two thirds vesting each of the three months thereafter in eight tranches. |
(4) | The exercise price per share. |