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Ownership Document
|
| Schema Version: X0306 |
| Document Type: 4/A |
| Period of Report: 6/1/20 |
| Date of Original Submission: 6/3/20 |
| Not Subject to Section 16: 0 |
| Issuer: |
| Issuer CIK: 805928 |
| Issuer Name: Axogen, Inc. |
| Issuer Trading Symbol: AXGN |
| Reporting Owner: |
| Reporting Owner ID: |
| | Owner CIK: 1403679 |
| | Owner Name: Rudelius Robert James |
| Reporting Owner Address: |
| | Owner Street 1: 13631 PROGRESS BOULEVARD |
| | Owner Street 2: SUITE 400 |
| | Owner City: ALACHUA |
| | Owner State: FL |
| | Owner ZIP Code: 32615 |
| | Owner State Description: |
| Reporting Owner Relationship: |
| | Is Director? Yes |
| | Is Officer? No |
| | Is Ten Percent Owner? No |
| | Is Other? No |
| | Officer Title: |
| | Other Text: |
| Non-Derivative Table: |
| Derivative Table: |
| Derivative Transaction: |
| | Security Title: |
| | | Value: Stock Option (right to purchase) |
| | Conversion or Exercise Price: |
| | | Value: 9.72 |
| | Transaction Date: |
| | | Value: 6/1/20 |
| | Transaction Coding: |
| | | Transaction Form Type: 4 |
| | | Transaction Code: A |
| | | Equity Swap Involved? No |
| | Transaction Amounts: |
| | | Transaction Shares: |
| Value: 12,605 |
| Footnote ID: F3 |
| | | Transaction Price Per Share: |
| Value: 0 |
| | | Transaction Acquired-Disposed Code: |
| Value: A |
| | Exercise Date: |
| | | Footnote ID: F1 |
| | Expiration Date: |
| | | Value: 6/1/30 |
| | Underlying Security: |
| | | Underlying Security Title: |
| Value: Common Stock |
| | | Underlying Security Shares: |
| Value: 12,605 |
| Footnote ID: F3 |
| | Post-Transaction Amounts: |
| | | Shares Owned Following Transaction: |
| Value: 12,605 |
| Footnote ID: F3 |
| | Ownership Nature: |
| | | Direct or Indirect Ownership: |
| Value: D |
| Derivative Transaction: |
| | Security Title: |
| | | Value: Restricted Stock Units |
| | Conversion or Exercise Price: |
| | | Footnote ID: F2 |
| | Transaction Date: |
| | | Value: 6/1/20 |
| | Transaction Coding: |
| | | Transaction Form Type: 4 |
| | | Transaction Code: A |
| | | Equity Swap Involved? No |
| | Transaction Amounts: |
| | | Transaction Shares: |
| Value: 6,173 |
| Footnote ID: F3 |
| | | Transaction Price Per Share: |
| Value: 0 |
| | | Transaction Acquired-Disposed Code: |
| Value: A |
| | Exercise Date: |
| | | Footnote ID: F1 |
| | Expiration Date: |
| | | Footnote ID: F1 |
| | Underlying Security: |
| | | Underlying Security Title: |
| Value: Common Stock |
| | | Underlying Security Shares: |
| Value: 6,173 |
| Footnote ID: F3 |
| | Post-Transaction Amounts: |
| | | Shares Owned Following Transaction: |
| Value: 6,173 |
| Footnote ID: F3 |
| | Ownership Nature: |
| | | Direct or Indirect Ownership: |
| Value: D |
| Footnotes: |
| Footnote - F1: Annual equity grant for service as Director on the Axogen, Inc. Board of Directors. The number of shares pursuant to the equity grant is based on a $120,000 valuation as of the grant date and vests on June 1, 2021, one year from the anniversary of the grant date. One-half of the annual equity grant value is in the form of non-qualified stock options and One-half of the annual equity grant value is in the form of restricted stock units. |
| Footnote - F2: Each restricted stock unit represents a contingent right to receive one share of Axogen, Inc. common stock. |
| Footnote - F3: The original Form 4, filed June 3, 2020, incorrectly stated the number of derivative securities (Column 5), the number of shares (Column 7) and number of derivatives securities beneficially owned following reported transaction (Column 9) for both the Stock Options and Restricted Stock Units. Footnote 1 has also been amended to reflect the accurate number of stock options and restricted stock units. |
| Owner Signature: |
| Signature Name: /s/Robert Rudelius |
| Signature Date: 6/12/20 |
