0001250853-22-000097.txt : 20221202 0001250853-22-000097.hdr.sgml : 20221202 20221202184133 ACCESSION NUMBER: 0001250853-22-000097 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220225 FILED AS OF DATE: 20221202 DATE AS OF CHANGE: 20221202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sim Kenneth T. CENTRAL INDEX KEY: 0001725499 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37392 FILM NUMBER: 221443313 MAIL ADDRESS: STREET 1: 1668 S. GARFIELD AVE. STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apollo Medical Holdings, Inc. CENTRAL INDEX KEY: 0001083446 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT CONSULTING SERVICES [8742] IRS NUMBER: 870042699 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1668 S. GARFIELD AVENUE STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 BUSINESS PHONE: (626) 282-0288 MAIL ADDRESS: STREET 1: 1668 S. GARFIELD AVENUE STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 FORMER COMPANY: FORMER CONFORMED NAME: SICLONE INDUSTRIES INC DATE OF NAME CHANGE: 19990413 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2022-02-25 0 0001083446 Apollo Medical Holdings, Inc. AMEH 0001725499 Sim Kenneth T. 1668 S. GARFIELD AVE. 2ND FLOOR ALHAMBRA CA 91801 1 1 0 0 Executive Chairman Common Stock 2022-02-25 5 G 0 E 258824 0 D 230576 I By Kenneth T & Simone S Sim Family Trust Common Stock 2022-09-27 5 G 0 E 392816 0 D 0 I By grantor retained annuity trust Common Stock 2022-09-27 5 G 0 E 392816 0 D 0 I By wife Common Stock 191827 D Common Stock 42996 I By Kenneth T. Sim Pension Plan Trust Common Stock 230688 I By grantor retained annuity trust Common Stock 11175702 I By Allied Physicians of California, A Professional Medical Corporation These securities are held by the Kenneth T & Simone S Sim Family Trust U/A dated 11/07/2013 (the Family Trust). The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. On September 17, 2020, the Reporting Person contributed 564,706 shares of AMEH common stock to a grantor retained annuity trust (the KS GRAT) for the benefit of himself and his children. On September 27, 2021 45,838 shares were distributed from the KS GRAT to the Family Trust in satisfaction of an annuity obligation. On September 22, 2022, 126,051 shares were distributed from the KS GRAT to the Family Trust in satisfaction of an annuity obligation. Upon termination of the trust on September 27, 2022, the remaining 392,816 shares were transferred to the children of the Reporting Person. The 171,889 shares previously distributed to the Family Trust will continue to be reported as indirectly owned by the Reporting Person. On September 17, 2020, the spouse of the Reporting Person contributed 564,706 shares of AMEH common stock to a grantor retained annuity trust (the SS GRAT) for the benefit of herself and her children. On September 27, 2021 45,838 shares were distributed from the SS GRAT to the Family Trust in satisfaction of an annuity obligation. On September 22, 2022, 126,051 shares were distributed from the SS GRAT to the Family Trust in satisfaction of an annuity obligation. Upon termination of the trust on September 27, 2022, the remaining 392,816 shares were transferred to the children of the Reporting Person. The 171,889 shares previously distributed to the Family Trust will continue to be reported as indirectly owned by the Reporting Person. These securities are held by the Kenneth T. Sim Pension Plan Trust U.A. dated 12/18/2007. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. These securities are held by a grantor retained annuity trust for the benefit of the Reporting Person and his children, separate from the KS GRAT referenced in Footnote 2. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. These securities are beneficially owned by Allied Physicians of California, A Professional Medical Corporation, of which the Reporting Person is a director, officer and shareholder. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. /s/ Kenneth T. Sim 2022-12-02