| FORM
4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities
Exchange Act of 1934
or Section 30(h) of the Investment Company Act of
1940
|
| OMB APPROVAL |
| OMB Number: |
3235-0287 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
|
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue.
See
Instruction 1(b).
|
1. Name and Address of Reporting Person
*
| C/O ALPHATEC SPINE, INC. |
| 1950 CAMINO VIDA ROBLE |
(Street)
|
2. Issuer Name
and
Ticker or Trading Symbol
Alphatec Holdings, Inc.
[
ATEC
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| EVP, Sales |
|
3. Date of Earliest Transaction
(Month/Day/Year)
05/17/2022
|
4. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check
Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting
Person |
|
| Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned |
|---|
| 1.
Title of Security (Instr.
3)
|
2.
Transaction Date
(Month/Day/Year) |
2A.
Deemed Execution Date, if any
(Month/Day/Year) |
3.
Transaction Code (Instr.
8)
|
4.
Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
|
5.
Amount of Securities Beneficially Owned Following Reported
Transaction(s) (Instr.
3 and 4)
|
6.
Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
7.
Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
Amount |
(A) or (D) |
Price |
|
Common Stock
|
05/17/2022 |
|
F |
|
34,087
|
D
|
$
8.26
|
580,409
|
D
|
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 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 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: 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: |
|
|
|
/s/ Tyson Marshall by power of attorney |
05/19/2022 |
|
** Signature of Reporting Person |
Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * 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). |
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
| 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 Number. |
POWER OF ATTORNEY
Know all by these present, that the undersigned hereby
constitutes and appoints Craig E. Hunsaker and Tyson E. Marshall
of Alphatec Holdings, Inc., and Rick L. Guerisoli of Durham Jones
& Pinegar, signing singly, the undersigned's true and lawful
attorney-in-fact, with full power and authority as hereinafter
described on behalf of and in the name, place and stead of the
undersigned, to:
(1) prepare, execute, acknowledge, deliver, submit, and file
for and on behalf of the undersigned, in the undersigneds
capacity as an officer and/or director and/or other insider of
Alphatec Holdings, Inc. or any successor entity (the "Company"),
an application for Form ID (or equivalent form) required to
generate the necessary access codes and passphrases (whether new
or replacement) to file on U.S. Securities & Commission's
Electronic Data Gathering, Analysis and Retrieval System
("EDGAR");
(2) prepare, execute, acknowledge, deliver, submit, and file
for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director and/or other insider of
the Company, Forms 3, 4, and 5 or any other forms or reports to
be filed in accordance with Section 16(a) of the Securities
Exchange Act of 1934 and the rules promulgated thereunder (the
"Exchange Act"), and any amendments thereto;
(3) seek or obtain, as the undersigned's representative and on
the undersigned's behalf, information on transactions in the
Company's securities from any third party, including brokers,
employee benefit plan administrators and trustees, and the
undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such
release of information;
(4) take any other action of any type whatsoever in connection
with the foregoing which, in the opinion of such attorney-in-
fact, may be of benefit to, in the best interest of, or legally
required by, the undersigned, it being understood that the
documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such
form and shall contain such terms and conditions as such
attorney-in-fact may approve in such attorney-in-fact's
discretion.
The undersigned hereby grants to such attorney-in-fact full power
and authority to do and perform any and every act and thing
whatsoever requisite, necessary, or proper to be done in the
exercise of any of the rights and powers herein granted, as fully
to all intents and purposes as the undersigned might or could do
if personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact's substitute or
substitutes, shall lawfully do or cause to be done by virtue of
this Power of Attorney and the rights and powers herein granted.
The undersigned acknowledges that: (i) this Power of Attorney
authorizes the attorney-in-fact to act in his discretion in
submitting information on transactions and holdings on
information provided to the attorney-in-fact without independent
verification of such information; (ii) the attorney-in-fact, in
serving in such capacity at the request of the undersigned, is
not assuming nor relieving, nor is the Company assuming nor
relieving, any of the undersigned's responsibilities to comply
with Section 16 or any other provision of the Exchange Act; (iii)
neither the Company nor the foregoing attorney-in-fact assume any
liability for the undersigned's responsibility to comply with the
requirement of the Exchange Act or any obligation or liability of
the undersigned for profit disgorgement under Section 16(b) of
the Exchange Act.
This Power of Attorney shall remain in full force and effect
until the undersigned is no longer required to file Forms 3, 4
and 5 with respect to the undersigned's holdings of and
transactions in securities issued by the Company, unless earlier
revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact. The undersigned hereby revokes any
and all powers of attorney previously executed with respect to
the matters covered herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 2nd day of April, 2019.
/s/ David Sponsel
Tweet
Share
E-mail
