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