0000899243-17-029304.txt : 20171220
0000899243-17-029304.hdr.sgml : 20171220
20171220154955
ACCESSION NUMBER: 0000899243-17-029304
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170921
FILED AS OF DATE: 20171220
DATE AS OF CHANGE: 20171220
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bosita Renato V. Jr.
CENTRAL INDEX KEY: 0001718877
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-10093
FILM NUMBER: 171266753
MAIL ADDRESS:
STREET 1: TEXAS BACK INSTITUTE
STREET 2: 6020 WEST PARKER ROAD #200
CITY: PLANO
STATE: TX
ZIP: 75025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fuse Medical, Inc.
CENTRAL INDEX KEY: 0000319016
STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047]
IRS NUMBER: 591224913
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1565 NORTH CENTRAL EXPRESSWAY
STREET 2: SUITE 220
CITY: RICHARDSON
STATE: TX
ZIP: 75080
BUSINESS PHONE: 469-862-3030
MAIL ADDRESS:
STREET 1: 1565 NORTH CENTRAL EXPRESSWAY
STREET 2: SUITE 220
CITY: RICHARDSON
STATE: TX
ZIP: 75080
FORMER COMPANY:
FORMER CONFORMED NAME: GOLF ROUNDS COM INC
DATE OF NAME CHANGE: 19991126
FORMER COMPANY:
FORMER CONFORMED NAME: AMERICAN METALS SERVICE INC
DATE OF NAME CHANGE: 19920703
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2017-09-21
2017-10-10
0
0000319016
Fuse Medical, Inc.
FZMD
0001718877
Bosita Renato V. Jr.
6020 WEST PARKER ROAD # 200
PLANO
TX
75093
1
0
0
0
Common Stock
2017-09-21
4
A
0
65000
0.20
A
65000
D
Common Stock
2017-09-21
4
A
0
1000000
0.20
A
1065000
D
This Form 4/A amends the price of the Issuer's common stock, par value $0.01 ("Common Stock"), on the original Form 4 filed on 10/10/2017. In consultation with a valuation firm, the Issuer's board of directors determined that at the time of the Reporting Person's acquisition, the Common Stock's fair market value was $0.20 per share.
In consultation with a valuation firm, the Issuer's board of directors determined that at the time of the Reporting Person's acquisition, the Common Stock's fair market value was $0.20 per share.
/s/ Renato V. Bosita Jr.
2017-12-19