0000950170-23-055269.txt : 20231025 0000950170-23-055269.hdr.sgml : 20231025 20231025171045 ACCESSION NUMBER: 0000950170-23-055269 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231023 FILED AS OF DATE: 20231025 DATE AS OF CHANGE: 20231025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chen Carey CENTRAL INDEX KEY: 0001737962 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39994 FILM NUMBER: 231346710 MAIL ADDRESS: STREET 1: 3055 TORRINGTON DRIVE CITY: BALL GROUND STATE: GA ZIP: 30107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fathom Digital Manufacturing Corp CENTRAL INDEX KEY: 0001836176 STANDARD INDUSTRIAL CLASSIFICATION: FABRICATED STRUCTURAL METAL PRODUCTS [3440] IRS NUMBER: 981571400 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1050 WALNUT RIDGE DRIVE CITY: HARTLAND STATE: WI ZIP: 53209 BUSINESS PHONE: 262-367-8254 MAIL ADDRESS: STREET 1: 1050 WALNUT RIDGE DRIVE CITY: HARTLAND STATE: WI ZIP: 53209 FORMER COMPANY: FORMER CONFORMED NAME: Fathom Digital Manufacturing DATE OF NAME CHANGE: 20211223 FORMER COMPANY: FORMER CONFORMED NAME: Altimar Acquisition Corp. II DATE OF NAME CHANGE: 20201211 4 1 ownership.xml 4 X0508 4 2023-10-23 0001836176 Fathom Digital Manufacturing Corp NONE 0001737962 Chen Carey C/O FATHOM DIGITAL MANUFACTURING CORPORATION, 1050 WALNUT RIDGE DRIVE HARTLAND WI 53029 true true false false Chief Executive Officer false Class A Common Stock 2023-10-23 4 A false 151515 A 225543 D Class A Common Stock 2023-10-23 4 A false 104911 A 330454 D Represents shares of Class A Common Stock underlying Restricted Stock Units ("RSUs") issued to the Reporting Person. Each RSU represents the contingent right to receive one share of the Issuer's Class A Common Stock. These RSUs vest on October 23, 2026, subject to the Reporting Person's continued service through such vesting date. On September 28, 2023, the Class A Common Stock of the Issuer underwent a 1-for-20 reverse stock split (the "Reverse Stock Split"). The amounts of securities listed herein have been adjusted to reflect the effect of the Reverse Stock Split. Represents shares of Class A Common Stock underlying Performance Stock Units ("PSUs") issued to the Reporting Person. Each PSU represents the contingent right to receive one share of the Issuer's Class A Common Stock. The PSUs will vest in six tranches, with each tranche subject to (i) the Company attaining certain stock price growth hurdles during certain performance periods for each tranche, and (ii) Mr. Chen's continued service through the later of (x) the fourth anniversary of October 23, 2023 and (y) the date on which a particular tranche's stock price growth hurdle is attained, subject to certification of the Compensation Committee of the Issuer's Board of Directors. /s/ Carey Chen, by Steve Gavin as Attorney-in-Fact 2023-10-25