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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Berkowitz Mortimer III C/O ALPHATEC HOLDINGS, INC. 5818 EL CAMINO REAL CARLSBAD, CA 92008 |
X |
/s/ Mortimer Berkowitz III | 06/19/2018 | |
**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) | This Form 4 is being filed to report (a) the pro rata distribution of 906,431 shares of the Issuer's common stock by HealthpointCapital Partners, L.P. to its limited partners for no consideration (the "Fund I Distribution"); (b) the pro rata distribution of 1,742,546 shares of the Issuer's common stock by HealthpointCapital Partners II, L.P. to its limited partners for no consideration (the "Fund II Distribution"); (c) the receipt of 2,807 shares of the Issuer's common stock by the Reporting Person in the Fund I Distribution as a limited partner of HealthpointCapital Partners, L.P.; and (d) the receipt of 8,396 shares of the Issuer's common stock by the Reporting Person in the Fund II Distribution as a limited partner of HealthpointCapital Partners II, L.P. |
(2) | The Reporting Person is a managing member of HGP LLC, which is the general partner of HealthpointCapital Partners, L.P. In addition, the Reporting Person is a managing member of HGP II, LLC, which is the general partner of HealthpointCapital Partners II, L.P. As such, the Reporting Person may be deemed to beneficially own the securities held by HealthpointCapital Partners, L.P. and HealthpointCapital Partners II, L.P. The Reporting Person, however, disclaims beneficial ownership of such shares except as to the extent of his pecuniary interest therein. |
(3) | Includes shares owned by the Reporting Person and shares owned by the Reporting Person's spouse. |
(4) | The Report Person is the managing member of Porcupine Investment Partners, LLC and may be deemed to beneficially own the securities held by Porcupine Investment Partners, LLC. The Reporting Person, however, disclaims beneficial ownership of such shares except as to the extent of his pecuniary interest therein. |