0001209191-21-041530.txt : 20210617
0001209191-21-041530.hdr.sgml : 20210617
20210617171426
ACCESSION NUMBER: 0001209191-21-041530
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210615
FILED AS OF DATE: 20210617
DATE AS OF CHANGE: 20210617
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ross Derek
CENTRAL INDEX KEY: 0001824726
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39515
FILM NUMBER: 211025729
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
2021-06-15
0
0001393584
American Well Corp
AMWL
0001824726
Ross Derek
C/O AMERICAN WELL CORPORATION
75 STATE STREET, 26TH FLOOR
BOSTON
MA
02109
1
0
0
0
Class A Common Stock
2021-06-15
4
A
0
14440
0.00
A
29938
D
Represents a grant of restricted stock units, which vest on the earlier of (i) the day immediately preceding the date of the first annual meeting of the stockholders following the grant date and (ii) the first anniversary of the grant date.
/s/ Bradford Gay as attorney-in-fact for Derek Ross
2021-06-17