0001553350-16-001958.txt : 20160429
0001553350-16-001958.hdr.sgml : 20160429
20160429160917
ACCESSION NUMBER: 0001553350-16-001958
CONFORMED SUBMISSION TYPE: 3/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160328
FILED AS OF DATE: 20160429
DATE AS OF CHANGE: 20160429
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: 0331
BUSINESS ADDRESS:
STREET 1: 450 NORTH BRAND BLVD.,
STREET 2: SUITE 600
CITY: GLENDALE
STATE: CA
ZIP: 91203
BUSINESS PHONE: 818-396-8050
MAIL ADDRESS:
STREET 1: 700 NORTH BRAND BLVD.,
STREET 2: SUITE 1400
CITY: GLENDALE
STATE: CA
ZIP: 91203
FORMER COMPANY:
FORMER CONFORMED NAME: SICLONE INDUSTRIES INC
DATE OF NAME CHANGE: 19990413
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lam Thomas S.
CENTRAL INDEX KEY: 0001664499
FILING VALUES:
FORM TYPE: 3/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37392
FILM NUMBER: 161606634
MAIL ADDRESS:
STREET 1: 1668 GARFIELD AVE., 2ND FLOOR
CITY: ALHAMBRA
STATE: CA
ZIP: 91801
3/A
1
lam3.xml
OWNERSHIP DOCUMENT
X0206
3/A
2016-03-28
2016-01-25
0
0001083446
Apollo Medical Holdings, Inc.
AMEH
0001664499
Lam Thomas S.
1668 S. GARFIELD AVENUE
2ND FLOOR
ALHAMBRA
CA
91801
1
0
0
0
Common Stock
0
I
See footnote
Series A Preferred Stock
2015-10-14
Common Stock
1111111
I
By Network Medical Management, Inc.
The Common Stock previously listed in Table I of the Form 3 filed by the Reporting Person on January 25, 2016, is in fact a derivative security, and is hereby deleted from Table I.
On March 28, 2016, the Issuer filed an Amended and Restated Certificate of Designation (the "Amended Certificate of Designation") which amended a provision of the Certificate of Designation dated October 15, 2015 (the "Original Certificate of Designation") that created the Issuer's Series A Preferred Stock (the "Series A Preferred Stock"), which was sold to the Reporting Party on October 15, 2015. The Amended Certificate of Designation changed a triggering event for the mandatory conversion of the Series A Preferred Stock. The Series A Preferred Stock had been mandatorily convertible if the Issuer receives aggregate gross proceeds of not less than $5,000,000 in one or more transactions for the sale of its equity securities or securities convertible into, or exchangeable for, equity securities (other than the transaction pursuant to which the Series A Preferred Stock is being issued).
The Amended Certificate of Designation now provides that the Series A Preferred Stock is mandatorily convertible if the Issuer receives aggregate gross proceeds of not less than $5,000,000 in one or more transactions for the sale of its equity securities or securities convertible into, or exchangeable for, equity securities (other than any transactions with the holder of the Series A Preferred Stock). Furthermore, the Amended Certificate of Designation provides that the Series A Preferred Stock and the Series B Preferred Stock will participate pro rata and pari passu in distributions upon the liquidation, winding up or dissolution of the company.
Represents securities held by Network Medical Management, Inc. ("NMM") prior to Reporting Person becoming a director of the Issuer.
These shares are owned directly by NMM, of which Reporting Person is a director, officer and shareholder. Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose.
/s/ Thomas S. Lam, M.D.
2016-04-14