0001213900-20-030538.txt : 20201007
0001213900-20-030538.hdr.sgml : 20201007
20201007175459
ACCESSION NUMBER: 0001213900-20-030538
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: Tompkins Mark N.
CENTRAL INDEX KEY: 0001455971
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-56036
FILM NUMBER: 201229727
MAIL ADDRESS:
STREET 1: APP. 1, VIA GUIDINO 23
CITY: LUGANO-PARADISO
STATE: V8
ZIP: 6900
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
ownership.xml
X0306
4
2020-10-05
0
0001769804
Augmedix, Inc.
NONE
0001455971
Tompkins Mark N.
APT. 1, VIA GUIDINO 23
LUGANO-PARADISO
V8
6900
SWITZERLAND
0
0
0
1
Former Director and 10% Owner
Common stock, par value $0.0001 per share
2020-10-05
4
J
0
16667
0
D
4733333
D
Common stock, par value $0.0001 per share
2020-10-05
4
J
0
2743333
0
D
1990000
D
The reporting person transferred an aggregate of 16,667 shares of the Issuer's common stock as consideration for services rendered to an affiliate of the reporting person by the recipients.
Pursuant to the terms of an Agreement and Plan of Merger and Reorganization, dated as of October 5, 2020, by and among the Issuer, August Acquisition Corp. ("Acquisition Sub"), and Augmedix Operating Company (f/k/a Augmedix, Inc.) ("Augmedix"), on October 5, 2020, Acquisition Sub merged with and into Augmedix, with Augmedix continuing as the surviving entity (the "Merger") and as the Issuer's wholly-owned subsidiary. As a condition to the Merger, pursuant to the terms of a stock cancellation agreement, the reporting person voluntarily surrendered and canceled 2,743,333 shares of the Issuer's common stock prior to the consummation of the Merger. The reporting person resigned as a director of the Issuer upon consummation of the Merger.
/s/ Mark N. Tompkins
2020-10-07