0001104659-23-126897.txt : 20231218
0001104659-23-126897.hdr.sgml : 20231218
20231218163304
ACCESSION NUMBER: 0001104659-23-126897
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231215
FILED AS OF DATE: 20231218
DATE AS OF CHANGE: 20231218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sim Kenneth T.
CENTRAL INDEX KEY: 0001725499
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37392
FILM NUMBER: 231494233
MAIL ADDRESS:
STREET 1: 1668 S. GARFIELD AVE.
STREET 2: 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]
ORGANIZATION NAME: 07 Trade & Services
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
1
tm2333076-3_4seq1.xml
OWNERSHIP DOCUMENT
X0508
4
2023-12-15
0
0001083446
Apollo Medical Holdings, Inc.
AMEH
0001725499
Sim Kenneth T.
1668 S. GARFIELD AVE.
2ND FLOOR
ALHAMBRA
CA
91801
1
1
0
0
Executive Chairman
0
Common Stock
2023-12-15
4
A
0
30000
0
A
321859
D
Common Stock
2023-12-15
4
A
0
30000
0
A
351859
D
Common Stock
2023-12-15
4
A
0
30000
0
A
381859
D
Common Stock
42996
I
By Kenneth T. Sim Pension Plan Trust
Common Stock
230688
I
By grantor retained annuity trust
Common Stock
520117
I
By Kenneth T & Simone S Sim Family Trust
Common Stock
7132698
I
By Allied Physicians of California, A Professional Medical Corporation
These securities are held by the Kenneth T. Sim Pension Plan Trust U.A. dated 12/18/2007. 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 held by the Kenneth T & Simone S Sim Family Trust U/A dated 11/07/2013. 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 beneficially owned by Allied Physicians of California, a Professional Medical Corporation, 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.
Restricted shares of the Issuer's common stock granted pursuant to the Issuer's 2015 Equity Incentive Plan. Provided the Reporting Person is still employed with the Issuer on the date of vesting, the shares of restricted stock shall vest in four equal annual installments beginning on a date during the first quarter of 2025 to be determined by the compensation committee of the Issuer's board of directors.
Restricted shares of the Issuer's common stock granted pursuant to the Issuer's 2015 Equity Incentive Plan. Provided the Reporting Person is still employed with the Issuer on the date of vesting, and subject to the achievement of a pre-established performance goal, the shares of restricted stock shall vest in four equal annual installments, beginning on a date during the first quarter of 2025 to be determined by the compensation committee of the Issuer's board of directors.
Restricted shares of the Issuer's common stock granted pursuant to the Issuer's 2015 Equity Incentive Plan. Provided the Reporting Person is still employed with the Issuer on the date of vesting, and subject to the achievement of a pre-established performance goal, the shares of restricted stock shall, based on the date the performance goal is achieved, vest either (i) in four equal annual installments, beginning on a date during the first quarter of 2025 to be determined by the compensation committee of the Issuer's board of directors or (ii) three annual installments of 15,000, 7,500 and 7,500, respectively, beginning on a date during the first quarter of 2026 to be determined by the compensation committee.
Includes 111,748 shares of restricted stock, which will vest as follows (in each case subject to continuous employment with the Issuer): (i) 21,748 shares, which vest on November 2, 2024; (ii) 30,000 shares, which vest in four equal annual installments beginning in the first quarter of 2025; (iii) 30,000 shares, which will vest upon achievement of certain pre-established performance goals; and (iv) 30,000 shares, which will vest upon achievement of certain pre-established performance goals.
/s/ Kenneth T. Sim
2023-12-15