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