Form 3 Paragon 28, Inc. For: Apr 18 Filed by: Edie Jason Allan
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 |
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1. Name and Address of Reporting Person
*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/18/2022 |
3. Issuer Name
and
Ticker or Trading Symbol
Paragon 28, Inc. [ FNA ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check
Applicable Line)
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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) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 |
Explanation of Responses: |
/s/ Jonathan Friedman, as Attorney-in-Fact for Jason Edie | 04/20/2022 | |
** 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. |
LIMITED POWER OF ATTORNEY FOR EDGAR ACCESS CODES
The undersigned hereby makes, constitutes and appoints John E Andrews and Patricia Bresnan, acting alone with full power of
substitution, to be the true and lawful attorney-in-fact (“Attorney”), for and in the name of the undersigned, to prepare and execute in the name and on behalf of the undersigned an Application for EDGAR Access (Form ID) and/or an Authentication of
the Form ID, or an Update Passphrase Application (collectively, the “Application”), and submit such Application and any other documents necessary or appropriate to obtain and/or regenerate EDGAR codes and passwords from the United States Securities
and Exchange Commission (the “SEC”) for the purpose of enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934, Regulation D of the Securities Act of 1933 or any
rule or regulation of the SEC.
The undersigned further grants to the Attorney full authority to act in any manner both proper and necessary to the exercise
of the foregoing powers and the undersigned ratifies every act that the Attorney may lawfully perform in exercising those powers.
This Limited Power of Attorney is effective immediately and will terminate once EDGAR codes for the undersigned have been
obtained by the Attorney from the SEC.
IN WITNESS WHEREOF, the undersigned has executed this Limited Power of Attorney this 6th day of April, 2022.
By: /s/ Jason Allan Edie
Name: Jason Allan Edie