Initial Statement of Beneficial Ownership (3)
06 Februar 2014 - 8:50PM
Edgar (US Regulatory)
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FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Plunkett Michael Joseph
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2. Date of Event Requiring Statement (MM/DD/YYYY)
12/27/2013
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3. Issuer Name
and
Ticker or Trading Symbol
Alphatec Holdings, Inc. [ATEC]
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(Last)
(First)
(Middle)
C/O ALPHATEC SPINE, INC., 5818 EL CAMINO REAL
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Chief Operating Officer /
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(Street)
CARLSBAD, CA 92008
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
(1)
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57718
(1)
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Incentive Stock Option
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3/19/2013
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3/19/2022
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Common Stock
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75000
(2)
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$2.17
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D
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Incentive Stock Option
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1/4/2014
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1/4/2023
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Common Stock
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65000
(2)
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$1.72
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D
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Incentive Stock Option
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8/8/2014
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8/8/2023
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Common Stock
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30000
(2)
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$2.04
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D
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Explanation of Responses:
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(
1)
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Of such common stock, 35,300 are subject to restricted stock agreements, which require the holder to remain an employee of the issuer in order for the common stock to vest over time.
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(
2)
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The options vest over four years with 25% vesting on the anniversary of the date of grant, and the remainder vesting in 12 tranches each three months thereafter.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Plunkett Michael Joseph
C/O ALPHATEC SPINE, INC.
5818 EL CAMINO REAL
CARLSBAD, CA 92008
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Chief Operating Officer
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Signatures
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/s/ Ebun S. Garner, Esq., Attorney-in-fact
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2/6/2014
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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