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