Filing Details

Accession Number:
0001140361-10-000702
Form Type:
4
Zero Holdings:
No
Publication Time:
2010-01-05 12:00:00
Reporting Period:
2009-12-31
Filing Date:
2010-01-05
Accepted Time:
2010-01-05 17:15:10
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1376339 Mimedx Group Inc. MDXG.OB Surgical & Medical Instruments & Apparatus (3841) 900300868
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
901434 H Parker Petit 9815 Highway 98W, Unit 930
Miramar Beach FL 32550
Chief Executive Officer Yes Yes No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2009-12-31 1,666,667 $0.60 1,682,222 No 4 P Direct
Common Stock Acquisiton 2009-12-31 100,000 $0.60 100,000 No 4 P Indirect By Parker H. Petit Grantor Trust
Common Stock Acquisiton 2009-12-31 100,000 $0.60 100,000 No 4 P Indirect By Petit Investments, LP
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
No 4 P Indirect By Parker H. Petit Grantor Trust
No 4 P Indirect By Petit Investments, LP
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock 5% Convertible Promissory Note Disposition 2009-12-31 0 $500,000.00 833,333 $0.60
Common Stock Common Stock Warrants (Right to Buy) Acquisiton 2009-12-31 833,333 $0.00 833,333 $1.50
Common Stock Common Stock Warrants (Right to Buy) Acquisiton 2009-12-31 50,000 $0.00 50,000 $1.50
Common Stock Common Stock Warrants (Right to Buy) Acquisiton 2009-12-31 50,000 $0.00 50,000 $1.50
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 2009-12-31 2009-12-31 No 4 C Direct
833,333 2010-01-01 2014-12-31 No 4 P Direct
50,000 2010-01-01 2014-12-31 No 4 P Indirect
50,000 2010-01-01 2014-12-31 No 4 P Indirect
Reported Derivative Holdings
Sec. Name Sec. Type Price Date Expiration Date Amount Remaning Holdings Nature of Ownership
Common Stock Common Stock Warrants (Right to Buy) $0.60 2009-12-21 2012-09-22 0 1,666,667 Direct
Expiration Date Amount Remaning Holdings Nature of Ownership
2012-09-22 0 1,666,667 Direct
Footnotes
  1. The 5% Convertible Promissory Note was paid in entirety by the issuer on 12/31/09.
  2. As a result of the above transaction, in conjunction with the 5% Convertible Promissory Note, the holder was issued warrants to purchase common stock, computed by dividing the aggregate amount of advances under the note by the conversion price and multiplying the resultant quotient by two. The number of derivative securities beneficially owned following the reported transaction on 10/15/09 was incorrectly stated, the revised amount is now properly stated.
  3. Received one warrant for every two shares of common stock purchased at $.60 per share.
  4. The reporting person is the trustee of the Trust. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.