| FORM
3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF
SECURITIES
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: |
3235-0104 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person
*
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year)
06/02/2021
|
3. Issuer Name
and
Ticker or Trading Symbol
SeaSpine Holdings Corp
[
SPNE
]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| President, Enabling Tech |
|
5. 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 Beneficially Owned |
|---|
| 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
|
36,308
|
D
|
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form: 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 |
|
Class B common shares of 7D Surgical ULC
(1)
|
|
|
Common Stock
|
304,950
|
0
|
I
|
Held by 2837165 Ontario Inc.
|
| Explanation of Responses: |
|
|
| Remarks: |
| Exhibit 24 - Power of Attorney. |
|
/s/Paul Benny, Attorney-in-Fact for Beau Standish |
06/04/2021 |
|
** 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 presents, that the undersigned hereby makes, constitutes
and appoints each of Patrick Keran, Noreen Blanchett, Paul Benny and John
Bostjancic or any of them acting singly, and with full power of substitution
and re-substitution, the undersigned's true and lawful attorney-in-fact
(each of such persons and their substitutes being referred to herein as
the "Attorney-in-Fact"), with full power to act for the undersigned and
in the undersigned's name, place and stead, in any and all capacities, to:
1.Prepare, execute, and submit to the Securities and Exchange Commission
("SEC") a Form ID, including amendments thereto, and any other documents
necessary or appropriate to obtain codes and passwords enabling the
undersigned to make electronic filings with the SEC of reports required
or considered by the Attorney-in-Fact to be advisable under Section 13 or
Section 16 of the Securities Exchange Act of 1934 (the "Exchange Act") or
any rule or regulation of the SEC;
2.Prepare, execute and submit to the SEC, SeaSpine Holdings Corporation
(the "Company"), and/or any national securities exchange on which the
Company's securities are listed any and all reports (including any amendments
thereto) the undersigned is required to file with the SEC, or which the
Attorney-in-Fact considers it advisable to file with the SEC, under
Section 13 or Section 16 of the Exchange Act or any rule or regulation
thereunder, or under Rule 144 under the Securities Act of 1933 ("Rule 144"),
with respect to the any security of the Company, including Forms 3, 4 and 5,
Schedules 13D and 13G, and Forms 144; and
3.Obtain, as the undersigned's representative and on the undersigned's behalf,
information regarding transactions in the Company's equity securities from
any third party, including the Company and any brokers, dealers, employee
benefit plan administrators and trustees, and the undersigned hereby
authorizes any such third party to release any such information to the
Attorney-in-Fact.
The undersigned acknowledges that:
a)This Power of Attorney authorizes, but does not require, the
Attorney-in-Fact to act in his or her discretion on information provided
to such Attorney-in-Fact without independent verification of such information;
b)Any documents prepared or executed by the Attorney-in-Fact on behalf of the
undersigned pursuant to this Power of Attorney will be in such form and will
contain such information as the Attorney-in-Fact, in his or her discretion,
deems necessary or desirable;
c)Neither the Company nor the Attorney-in-Fact assumes any liability for
the undersigned's responsibility to comply with the requirements of Section 13
or Section 16 of the Exchange Act or Rule 144, any liability of the
undersigned for any failure to comply with such requirements, or any liability
of the undersigned for disgorgement of profits under Section 16(b) of the
Exchange Act; and
d)This Power of Attorney does not relieve the undersigned from responsibility
for compliance with the undersigned's obligations under Section 13 or
Section 16 of the Exchange Act, including, without limitation, the reporting
requirements under Section 13 or Section 16 of the Exchange Act.
The undersigned hereby grants to the Attorney-in-Fact full power and authority
to do and perform each and every act and thing requisite, necessary or
advisable to be done in connection with the foregoing, as fully, to all intents
and purposes, as the undersigned might or could do in person, hereby ratifying
and confirming all that the Attorney-in-Fact, or his or her substitute or
substitutes, shall lawfully do or cause to be done by authority of this
Power of Attorney.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 4 or 5 or Schedules 13D
or 13G or Forms 144 with respect to the undersigned's holdings of and
transactions in securities of the Company, unless earlier revoked by the
undersigned in a signed writing delivered to the Attorney-in-Fact. This
Power of Attorney revokes all previous powers of attorney with respect
to the subject matter of this Power of Attorney.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney
as of the date set forth below.
Date: May 20, 2021
Signature:/s/Beau Standish
Printed Name: Beau Standish
Tweet
Share
E-mail
