0001628280-21-021872.txt : 20211104
0001628280-21-021872.hdr.sgml : 20211104
20211104202554
ACCESSION NUMBER: 0001628280-21-021872
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211102
FILED AS OF DATE: 20211104
DATE AS OF CHANGE: 20211104
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: 211381887
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
wf-form4_163607193862764.xml
FORM 4
X0306
4
2021-11-02
0
0001083446
Apollo Medical Holdings, Inc.
AMEH
0001664499
Lam Thomas S.
1668 S GARFIELD AVE 2ND FLOOR
ALHAMBRA
CA
91801
1
1
0
0
President and Co-CEO
Common Stock
2021-11-02
4
A
0
65242
0
A
191827
D
Common Stock
908183
I
By the Thomas and Jeanette Lam 2002 Family Trust
Common Stock
564691
I
By grantor retained annuity trust
Common Stock
564691
I
By wife
Common Stock
10925702
I
By Allied Physicians of California, a Professional Medical Corporation
Stock Option (right to buy)
71.45
2021-11-02
4
A
0
29502
0
A
2026-11-02
Common Stock
29502.0
29502
D
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, 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.
Provided the Reporting Person is still employed with the Issuer on the following dates, the option shall vest in three equal annual installments commencing on the first anniversary of November 2, 2021.
/s/ Thomas S. Lam
2021-11-04