X0206 3/A 2016-12-19 2016-12-29 0 0000319016 Fuse Medical, Inc. FZMD 0001688080 Reeg Christopher C 3024 WESTMINSTER AVENUE DALLAS TX 75205 1 1 1 0 Chief Executive Officer Common Stock 4000000 I By Reeg Medical Industries, Inc. Amended and Restated Promissory Note 0.08 2017-01-16 Common Stock 650000 I By Reeg Medical Industries, Inc. These securities are directly owned by Reeg Medical Industries, Inc. ("RMI"), a Texas corporation. Christopher C. Reeg is the sole shareholder, sole director, and sole officer of RMI. Accordingly, Christopher C. Reeg indirectly beneficially owns the reported securities. The Amended and Restated Promissory Note, dated October 19, 2016, made by the Issuer and payable to the order of RMI, in the principal amount of $50,000 ("Note") became payable upon demand on December 19, 2016, and will be convertible into shares of common stock of the Issuer on or after January 16, 2017. The Note does not provide for a stated expiration date. On or after January 16, 2017, RMI will have the right to convert all or any portion of the then unpaid principal and interest balance of the Note into shares of common stock of the Issuer at a conversion price of $0.08 per share. The number of shares reported in box 3 is based on the application of such conversion rate to the amount of principal and interest that will be outstanding on January 16, 2017, if the Note remains outstanding on such date. /s/ Christopher C. Reeg 2018-01-26