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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
NQ Stock Option | $ 2.05 | 12/19/2012 | A | 103,925 (2) | 12/19/2013(3) | 12/19/2019 | Common Stock | 103,925 | $ 2.05 (1) | 178,925 | D | ||||
Incentive Stock Option | $ 1.28 | 03/06/2010 | 03/06/2019 | Common Stock | 20,000 | 75,000 | D | ||||||||
Incentive Stock Option | $ 2.31 | 11/04/2011 | 11/04/2010 | Common Stock | 55,000 | 55,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Garner Ebun C/O ALPHATEC HOLDINGS, INC. 2051 PALOMAR AIRPORT ROAD CARLSBAD, CA 92011 |
General Counsel and SVP |
/s/ Ebun S. Garner | 12/31/2012 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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) | Exercise price per share |
(2) | This option grant was made after the holder agreed to forfeit 103,925 options previously granted to him. This transaction is described in greater detail in a Schedule TO that the issuer filed with the SEC on December 19, 2012. |
(3) | The options vest over thre years with one third vesting on the anniversary of the grant date and the remaining two thirds vesting in eicht tranches every three months thereafter. |