Initial Statement of Beneficial Ownership (3)
June 19 2020 - 5:07PM
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
OMB Number:
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
*
Pelizzon David R |
2. Date of Event Requiring Statement (MM/DD/YYYY)
6/17/2020
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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 |
4. 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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(Street)
CARLSBAD, CA 92008
(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 | 115997 | D | |
Common Stock | 1086957 | I | By Squadron Capital LLC (1) |
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 |
Warrants (right to buy) | 5/29/2027 | 5/29/2034 | Common Stock | 456000 | $3.15 | I | By Squadron Capital LLC (1) |
Warrants (right to buy) | 5/29/2027 | 5/29/2034 | Common Stock | 2419355 | $2.17 | I | By Squadron Capital LLC (1) |
Warrants (right to buy) | 5/29/2027 | 5/29/2034 | Common Stock | 537910 | $4.88 | I | By Squadron Capital LLC (1) |
Explanation of Responses: |
(1) | These securities are held by Squadron Capital LLC ("Squadron"). As the President of Squadron, the reporting person may be deemed to be the beneficial owner of these securities. The reporting person expressly disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed to be an admission of beneficial ownership for purposes of Section 16 or for any other purpose. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Pelizzon David R C/O ALPHATEC SPINE, INC. 5818 EL CAMINO REAL CARLSBAD, CA 92008 | X |
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Signatures
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/s/ David R. Pelizzon | | 6/19/2020 |
**Signature of Reporting Person | Date |
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