0001250853-22-000118.txt : 20221207
0001250853-22-000118.hdr.sgml : 20221207
20221207190434
ACCESSION NUMBER: 0001250853-22-000118
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221205
FILED AS OF DATE: 20221207
DATE AS OF CHANGE: 20221207
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lam Thomas S.
CENTRAL INDEX KEY: 0001664499
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37392
FILM NUMBER: 221451161
MAIL ADDRESS:
STREET 1: 1668 GARFIELD AVE., 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
2022-12-05
0
0001083446
Apollo Medical Holdings, Inc.
AMEH
0001664499
Lam Thomas S.
1668 GARFIELD AVE., 2ND FLOOR
ALHAMBRA
CA
91801
1
1
0
0
President and Co-CEO
Common Stock
2022-12-05
4
M
0
51443
10
A
243270
D
Common Stock
2022-12-05
4
M
0
48585
11
A
291855
D
Common Stock
1107474
I
By the Thomas and Jeanette Lam 2002 Family Trust
Common Stock
10191660
I
By Allied Physicians of California, A Professional Medical Corporation
Warrants to purchase Common Stock
10
2022-12-05
4
M
0
51442.83
D
2017-12-08
2022-12-08
Common Stock
51442.83
0
D
Warrants to purchase Common Stock
11
2022-12-05
4
M
0
48585.84
D
2017-12-08
2022-12-08
Common Stock
48585.84
0
D
These securities are beneficially owned by Allied Physicians of California, A Profession 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.
On December 8, 2017, a reverse merger transaction between the Issuer and Network Medical Management, Inc. ("NMM") was consummated such that NMM became a wholly-owned subsidiary of the Issuer (the "Merger). Immediately prior to the closing of the Merger, the Reporting Person was a shareholder of NMM. Pursuant to the Merger, the shares of NMM common stock previously held by Reporting Person were converted into (i) 1,563,763 shares of common stock of the Issuer, (ii) a warrant to purchase 48,585.84 shares of common stock of the Issuer at an exercise price of $11.00 per share , (iii) a warrant to purchase 51,443.83 shares of common stock of the Issuer at an exercise price of $10.00 per share, (iv) cash in lieu of fractional shares, and (v) the Reporting Person's pro rata portion, if any, of the holdback shares of common stock of the Issuer (such pro rata portion of the holdback shares would, without offset, initially be equal to 173,751.48 shares of common stock of the Issuer).
/s/ Thomas S. Lam
2022-12-07