0001250853-21-000044.txt : 20210401
0001250853-21-000044.hdr.sgml : 20210401
20210401204615
ACCESSION NUMBER: 0001250853-21-000044
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210330
FILED AS OF DATE: 20210401
DATE AS OF CHANGE: 20210401
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lam Thomas S.
CENTRAL INDEX KEY: 0001664499
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37392
FILM NUMBER: 21800272
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
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2021-03-30
0
0001083446
Apollo Medical Holdings, Inc.
AMEH
0001664499
Lam Thomas S.
1668 GARFIELD AVE., 2ND FLOOR
ALHAMBRA
CA
91801
1
1
0
0
President and Co-CEO
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
10685119
I
By Allied Physicians of California, a Professional Medical Corporation
Warrant to Purchase Common Stock
10
2021-03-30
4
M
0
31755
0
D
2017-12-07
2021-03-30
Common Stock
31755
0
I
By the Thomas and Jeanette Lam 2002 Family Trust
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 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.
/s/ Thomas S. Lam
2021-04-01