0001553350-18-000259.txt : 20180329 0001553350-18-000259.hdr.sgml : 20180329 20180329214237 ACCESSION NUMBER: 0001553350-18-000259 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171208 FILED AS OF DATE: 20180329 DATE AS OF CHANGE: 20180329 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: 18724712 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: 0331 BUSINESS ADDRESS: STREET 1: 700 NORTH BRAND BLVD., STREET 2: SUITE 1400 CITY: GLENDALE STATE: CA ZIP: 91203 BUSINESS PHONE: 818-839-5200 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 4/A 1 lam4.xml OWNERSHIP DOCUMENT X0306 4/A 2017-12-08 2017-12-12 0 0001083446 Apollo Medical Holdings, Inc. AMEH 0001664499 Lam Thomas S. 1668 S. GARFIELD AVENUE 2ND FLOOR ALHAMBRA CA 91801 1 1 0 0 Co-Chief Executive Officer Common Stock 2017-12-08 4 J 0 1563763 A 1563763 D Common Stock 2017-12-08 4 J 0 1682109 A 1682109 I By Allied Physicians of California, A Professional Medical Corporation ("Allied") On December 8, 2017, a reverse merger transaction between the Issuer and Network Medical Management, Inc. ("NMM") was consummated such that NMM became a wholly-owned subsidiary of the Issuer (the "Merger"). Pursuant to and effective as of the closing of the Merger (the "Closing"), the Reporting Person became an officer (i.e., Executive Chairman) and director of the Issuer. Immediately prior to the Closing, the Reporting Person was a shareholder of NMM. Pursuant to the Merger, the shares of NMM common stock previously held by Reporting Person were converted into (i) 1,563,763 shares of common stock of the Issuer, (ii) a warrant to purchase 48,585.84 shares of common stock of the Issuer at an exercise price of $11.00 per share (this was previously reported on the Form 4 filed by the Reporting Person on December 12, 2017), (iii) a warrant to purchase 51,443.83 shares of common stock of the Issuer at an exercise price of $10.00 per share (this was previously reported on the Form 4 filed by the Reporting Person on December 12, 2017), (iv) cash in lieu of fractional shares, and (v) the Reporting Person's pro rata portion, if any, of the holdback shares of common stock of the Issuer (such pro rata portion of the holdback shares would, without offset, initially be equal to 173,751.48 shares of common stock of the Issuer). These shares and warrants are owned directly by Allied Physicians of California, A Professional Medical Corporation ("Allied"), 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. Immediately prior to the Closing, Allied was a shareholder of NMM. Pursuant to the Merger, the shares of NMM common stock previously held by Allied were converted into (i) 1,682,109 shares of common stock of the Issuer, (ii) a warrant to purchase 52,262.84 shares of common stock of the Issuer at an exercise price of $11.00 per share (this was previously reported on the Form 4/A filed by the Reporting Person on December 18, 2017), (iii) a warrant to purchase 55,337.13 shares of common stock of the Issuer at an exercise price of $10.00 per share (this was previously reported on the Form 4/A filed by the Reporting Person on December 18, 2017), (iv) cash in lieu of fractional shares, and (v) Allied's pro rata portion, if any, of the holdback shares of common stock of the Issuer (such pro rata portion of the holdback shares would, without offset, initially be equal to 186,901.07 shares of common stock of the Issuer). This Form 4/A reflects holdings as of December 8, 2017. This Form 4/A is being filed to correct a miscalculation in the number of shares of common stock deemed to be beneficially owned by the Reporting Person as of such date. /s/ Thomas S. Lam, M.D. 2018-03-29