0001209191-20-058832.txt : 20201117 0001209191-20-058832.hdr.sgml : 20201117 20201117174150 ACCESSION NUMBER: 0001209191-20-058832 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201113 FILED AS OF DATE: 20201117 DATE AS OF CHANGE: 20201117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ANDERSON KEITH CENTRAL INDEX KEY: 0001059226 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39515 FILM NUMBER: 201322215 MAIL ADDRESS: STREET 1: AMERICAN WELL CORPORATION STREET 2: 75 STATE STREET, 26TH FLOOR CITY: BOSTON STATE: MA ZIP: 02109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: American Well Corp CENTRAL INDEX KEY: 0001393584 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 75 STATE STREET STREET 2: 26TH FLOOR CITY: Boston STATE: MA ZIP: 02109 BUSINESS PHONE: 617-205-3500 MAIL ADDRESS: STREET 1: 75 STATE STREET STREET 2: 26TH FLOOR CITY: Boston STATE: MA ZIP: 02109 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-11-13 0 0001393584 American Well Corp AMWL 0001059226 ANDERSON KEITH C/O AMERICAN WELL CORPORATION 75 STATE STREET, 26TH FLOOR BOSTON MA 02109 0 1 0 0 Chief Financial Officer Class A Common Stock 2020-11-13 4 F 0 65185 29.04 D 1249886 D Class A Common Stock 741875 I By Keith W. Anderson 2020 Irrevocable Family Trust /s/ Bradford Gay as attorney-in-fact for Keith Anderson 2020-11-17