Filing Details
- Accession Number:
- 0001140361-11-000945
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2011-01-04 17:38:35
- Reporting Period:
- 2010-12-31
- Filing Date:
- 2011-01-04
- Accepted Time:
- 2011-01-04 17:38:35
- SEC Url:
- Form 4 Filing
Issuer
Cik | Name | Symbol | Sector (SIC) | IRS No |
---|---|---|---|---|
1376339 | Mimedx Group Inc. | MDXG | Surgical & Medical Instruments & Apparatus (3841) | 900300868 |
Insiders
Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
---|---|---|---|---|---|---|---|
901434 | H Parker Petit | C/O Mimedx Group, Inc. 811 Livingston Court, Suite B Marietta GA 30067 | Chief Executive Officer | No | Yes | Yes | 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 | 2010-11-15 | 600,000 | $1.00 | 3,630,258 | No | 4 | P | Direct |
Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|
No | 4 | P | Direct |
Reported Derivative Transactions
Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
---|---|---|---|---|---|---|---|
Common Stock | 5% Convertible Promissory Note | Acquisiton | 2010-10-20 | 150,000 | $0.00 | 150,000 | $1.00 |
Common Stock | Warrant | Acquisiton | 2010-10-20 | 150,000 | $1.00 | 150,000 | $1.00 |
Common Stock | 5% Convertible Promissory Note | Acquisiton | 2010-11-04 | 250,000 | $0.00 | 250,000 | $1.00 |
Common Stock | Warrant | Acquisiton | 2010-11-04 | 250,000 | $1.00 | 250,000 | $1.00 |
Common Stock | Warrant | Disposition | 2010-12-31 | 280,000 | $0.60 | 280,000 | $0.60 |
Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
---|---|---|---|---|---|---|
3,066,666 | 2010-10-21 | 2010-12-31 | No | 4 | P | Direct |
3,216,666 | 2011-01-01 | 2013-10-20 | No | 4 | P | Direct |
3,466,666 | 2010-11-05 | 2010-12-31 | No | 4 | P | Direct |
3,716,666 | 2011-01-01 | 2013-11-04 | No | 4 | P | Direct |
3,736,666 | 2009-12-21 | 2012-09-22 | No | 4 | G | Direct |
Reported Derivative Holdings
Sec. Name | Sec. Type | Price | Date | Expiration Date | Amount | Remaning Holdings | Nature of Ownership |
---|---|---|---|---|---|---|---|
Common Stock | Warrant | $1.50 | 2011-01-01 | 2015-11-15 | 300,000 | 4,016,666 | Direct |
Expiration Date | Amount | Remaning Holdings | Nature of Ownership |
---|---|---|---|
2015-11-15 | 300,000 | 4,016,666 | Direct |
Footnotes
- Number of shares held directly by Mr. Petit. Mr. Petit also beneficially owns 150,000 shares held by the Parker H. Petit Grantor Trust, of which he serves as the Trustee; 150,000 shares held by Petit Investments LP of which he serves as General Partner and Limited Partner and possesses shared voting and investment control; and 975,000 shares held by Cox Road Partners II LLP, 975,000 shares held by Cox Road Partners LLLP, and 975,000 shares held by Petit Investments LLLP II, limited liability limited partnerships over which Mr. Petit possesses sole voting and investment control.
- In conjunction with the 5% Convertible Promissory Note, the holder was issued warrants to purchase common stock.
- In conjunction with the purchase of common stock listed in table 1 above, the holder was issued warrants to purchase common stock.