0001209191-20-061577.txt : 20201203
0001209191-20-061577.hdr.sgml : 20201203
20201203174743
ACCESSION NUMBER: 0001209191-20-061577
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201201
FILED AS OF DATE: 20201203
DATE AS OF CHANGE: 20201203
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: 201367910
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
2020-12-01
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
2020-12-01
4
F
0
17075
26.54
D
1232811
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
2020-12-03