Statement of Changes in Beneficial Ownership (4)
26 Januar 2021 - 12:10AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
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TULLIS JAMES L L |
2. Issuer Name and Ticker or Trading Symbol
Alphatec Holdings, Inc.
[
ATEC
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O ALPHATEC SPINE, INC., 5818 EL CAMINO REAL |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/18/2020 |
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(Street)
CARLSBAD, CA 92008
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Common Stock | 12/18/2020 | | G |
V
| 29 | D | $0 | 127705 | D | |
| Common Stock | 1/21/2021 | | J(1) | | 400000 (1) | D | $0 | 315828 | I | By Tullis Growth Fund, L.P. |
| Common Stock | 1/21/2021 | | J(1) | | 4714 (1) | A | $0 | 132419 | D | |
| Common Stock | | | | | | | | 1143803 | I | By Tullis Dickerson Capital Focus III, LP |
| Common Stock | | | | | | | | 116355 | I | By Tullis-Dickerson Partners III, LLC |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security
(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 |
| Explanation of Responses: |
| (1) | On January 21, 2021, Tullis Growth Fund, L.P. distributed 400,000 shares to its partners on a pro rata basis (392,000 shares to its limited partners, and 8,000 shares to its General Partner, Tullis Growth Partners LLC, which in turn distributed such shares to its members). The reporting person received 4,003 shares as a result of the distribution from Tullis Growth Partners, LLC and 711 shares as a result of the distribution to the limited partners. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
TULLIS JAMES L L
C/O ALPHATEC SPINE, INC.
5818 EL CAMINO REAL
CARLSBAD, CA 92008 | X |
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Signatures
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| /s/ James L.L. Tullis | | 1/25/2021 |
| **Signature of Reporting Person | Date |
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