UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 386,997 | $ 0 | I | Shares owned by Woods 1994 Family Partnership, LP. (1) |
Warrants (right to buy) | Â (3) | Â (3) | Common Stock | 500,000 | $ 2 | I | Shares owned by Woods 1994 Family Partnership, LP. (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
WOODS WARD W JR C/O ALPHATEC SPINE, INC. 5818 EL CAMINO REAL CARLSBAD, CA 92008 |
 X |  |  |  |
/s/ Ward W. Woods | 01/29/2018 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Reporting Person is President of North Hailey Corporation, which is the general partner and managing member of Woods 1994 Family Partnership, LP. |
(2) | Each share of Series A Convertible Preferred Stock has no expiration date and is convertible into 500 shares of the Issuer's common stock following the date that shareholders approve such conversion, which approval was obtained on June 15, 2017. |
(3) | Each Warrant is exercisable for 1 share of the issuer's common stock for a period of five years following that date that shareholder approval is obtained, which approval was obtained on June 15, 2017. |