0001209191-20-054209.txt : 20201007 0001209191-20-054209.hdr.sgml : 20201007 20201007183450 ACCESSION NUMBER: 0001209191-20-054209 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201005 FILED AS OF DATE: 20201007 DATE AS OF CHANGE: 20201007 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DCM VI, L.P. CENTRAL INDEX KEY: 0001452273 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56036 FILM NUMBER: 201229821 BUSINESS ADDRESS: STREET 1: 2420 SAND HILL ROAD STREET 2: SUITE 200 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650 233 1400 MAIL ADDRESS: STREET 1: 2420 SAND HILL ROAD STREET 2: SUITE 200 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: A-Fund, L.P. CENTRAL INDEX KEY: 0001518379 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56036 FILM NUMBER: 201229822 BUSINESS ADDRESS: STREET 1: 2420 SAND HILL ROAD, SUITE 200 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-233-1400 MAIL ADDRESS: STREET 1: 2420 SAND HILL ROAD, SUITE 200 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Augmedix, Inc. CENTRAL INDEX KEY: 0001769804 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 833299164 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2255 GLADES ROAD STREET 2: SUITE 324A CITY: BOCA RATON STATE: FL ZIP: 33431 BUSINESS PHONE: 561-989-2208 MAIL ADDRESS: STREET 1: 2255 GLADES ROAD STREET 2: SUITE 324A CITY: BOCA RATON STATE: FL ZIP: 33431 FORMER COMPANY: FORMER CONFORMED NAME: Malo Holdings Corp DATE OF NAME CHANGE: 20190305 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-10-05 0 0001769804 Augmedix, Inc. NONE 0001452273 DCM VI, L.P. 2420 SAND HILL ROAD SUITE 200 MENLO PARK CA 94025 1 0 1 0 0001518379 A-Fund, L.P. 2420 SAND HILL ROAD SUITE 200 MENLO PARK CA 94025 1 0 1 0 Common Stock 2020-10-05 4 A 0 3064751 A 3064751 D Common Stock 2020-10-05 4 P 0 666667 3.00 A 3731418 D Common Stock 2020-10-05 4 A 0 20007 A 20007 I See footnote Warrant (right to buy) 2.88 2020-10-05 4 A 0 269490 A 2029-09-02 Common Stock 269490 269490 D On October 5, 2020, the Issuer's wholly-owned subsidiary, August Acquisition Corp. ("Acquisition Sub"), merged with and into Augmedix, Inc., a privately held Delaware corporation ("Augmedix"). Pursuant to this transaction (the "Merger"), Augmedix was the surviving corporation and became the Issuer's wholly owned subsidiary. All of the outstanding shares of stock of Augmedix held by accredited investors were converted into shares of the Issuer's common stock. All of the outstanding warrants, options and stock appreciation rights of Augmedix were assumed by the Issuer. These securities are held of record by DCM VI, L.P. ("DCM VI"). Jason Krikorian, a member of the Issuer's board of directors, is a general partner at DCM, which is an affiliate of DCM VI. These securities are held of record by A-Fund, L.P. ("A-Fund"). Jason Krikorian, a member of the Issuer's board of directors, is a general partner at DCM, which is an affiliate of A-Fund. The warrants are fully vested and exerciseable. DCM VI, L.P. By /s/ Matthew Bonner, Chief Operating Officer & Legal Partner A-FUND, L.P. By /s/ Matthew Bonner, Chief Operating Officer & Legal Partner 2020-10-07