Initial Statement of Beneficial Ownership (3)
December 05 2019 - 3:38PM
Edgar (US Regulatory)
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
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3235-0104
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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
*
Rich Terry M. |
2. Date of Event Requiring Statement (MM/DD/YYYY)
11/29/2019
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3. Issuer Name and Ticker or Trading Symbol
RTI Surgical Holdings, Inc. [RTIX]
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(Last)
(First)
(Middle)
520 LAKE COOK ROAD, SUITE 315 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
President, Global Spine / |
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(Street)
DEERFIELD, IL 60015
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 125598 (1) | D | |
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) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 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 |
| Option to purchase common stock | (2) | 11/29/2029 | Common stock | 188397 | $2.09 | D | |
| Explanation of Responses: |
| (1) | On the first anniversary of the Grant Date, 41,866 shares will vest. The remaining shares will vest on the last day of each calendar quarter at a rate of 10,466.5 shares per calendar quarter commencing on the fifteenth month following the Grant Date and continuing for two years year after. Vesting of these shares may accelerate upon the occurrence of certain conditions. |
| (2) | On the first anniversary of the Grant Date, 62,799 will vest. The remaining shares will vest on the last day of each calendar quarter at a rate of 15,699.75 shares per calendar quarter commencing on the fifteenth month following the Grant Date and continuing for two years after. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Rich Terry M.
520 LAKE COOK ROAD
SUITE 315
DEERFIELD, IL 60015 |
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| President, Global Spine |
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Signatures
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| /s/ Terry M. Rich | | 12/5/2019 |
| **Signature of Reporting Person | Date |
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