0001104659-21-062587.txt : 20210506 0001104659-21-062587.hdr.sgml : 20210506 20210506191255 ACCESSION NUMBER: 0001104659-21-062587 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201222 FILED AS OF DATE: 20210506 DATE AS OF CHANGE: 20210506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lam Thomas S. CENTRAL INDEX KEY: 0001664499 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37392 FILM NUMBER: 21899674 MAIL ADDRESS: STREET 1: 1668 GARFIELD AVE., 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apollo Medical Holdings, Inc. CENTRAL INDEX KEY: 0001083446 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT CONSULTING SERVICES [8742] IRS NUMBER: 870042699 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1668 S. GARFIELD AVENUE STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 BUSINESS PHONE: (626) 282-0288 MAIL ADDRESS: STREET 1: 1668 S. GARFIELD AVENUE STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 FORMER COMPANY: FORMER CONFORMED NAME: SICLONE INDUSTRIES INC DATE OF NAME CHANGE: 19990413 4/A 1 tm2115461-1_4seq1.xml OWNERSHIP DOCUMENT X0306 4/A 2020-12-22 2021-04-01 0 0001083446 Apollo Medical Holdings, Inc. AMEH 0001664499 Lam Thomas S. 1668 S. GARFIELD AVE., 2ND FL. ALHAMBRA CA 91801 1 1 0 0 President and Co-CEO Common Stock 2020-12-22 4 J 0 185938 0 A 876428 I By the Thomas and Jeanette Lam 2002 Family Trust Common Stock 2021-03-30 4 M 0 31755 10 A 908183 I By the Thomas and Jeanette Lam 2002 Family Trust Common Stock 126585 D Common Stock 564691 I By grantor retained annuity trust Common Stock 564691 I By wife Common Stock 10887594 I By Allied Physicians of California, a Professional Medical Corporation Represents the receipt of shares of the issuer pursuant to a pro rata in-kind distribution by Allied Physicians of California, A Profession Medical Corporation ("Allied") of which the Reporting Person is a director, officer and shareholder. These securities are held by the Thomas and Jeanette Lam 2002 Family Trust U/A dated 09/06/2002. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. These securities are held by a grantor retained annuity trust for the benefit of the Reporting Person and his children. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. These securities are beneficially owned by the Reporting Person's spouse as separate property. The Reporting Person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. These securities are beneficially owned by Allied, of which the Reporting Person is a director, officer and shareholder. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. /s/ Thomas S. Lam 2021-05-06