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