0001213900-19-024151.txt : 20191119
0001213900-19-024151.hdr.sgml : 20191119
20191119195925
ACCESSION NUMBER: 0001213900-19-024151
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191119
FILED AS OF DATE: 20191119
DATE AS OF CHANGE: 20191119
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: VENKATARAMAN BALAJI
CENTRAL INDEX KEY: 0001114916
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39138
FILM NUMBER: 191232764
MAIL ADDRESS:
STREET 1: FIRST HORIZON PHARMACEUTICAL CORP
STREET 2: 660 HEMBREE PKWY STE 106
CITY: ROSWELL
STATE: GA
ZIP: 30076
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Amplitude Healthcare Acquisition Corp
CENTRAL INDEX KEY: 0001788028
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 842984849
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1177 AVENUE OF THE AMERICAS FL 40
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 212- 823-1900
MAIL ADDRESS:
STREET 1: 1177 AVENUE OF THE AMERICAS FL 40
CITY: NEW YORK
STATE: NY
ZIP: 10036
3
1
ownership.xml
X0206
3
2019-11-19
0
0001788028
Amplitude Healthcare Acquisition Corp
AMHCU
0001114916
VENKATARAMAN BALAJI
1177 AVENUE OF THE AMERICAS, FL 40
NEW YORK
NY
10036
1
1
1
0
Chief Executive Officer
Class B Common Stock
Class A Common Stock
2875000
I
See Footnote
These shares represent the Class B common stock of the issuer held by Amplitude Healthcare Holdings LLC (the "Sponsor") acquired pursuant to a subscription agreement by and between the Sponsor and the issuer. The Class B common stock owned by the Sponsor includes up to 375,000 shares that are subject to forfeiture in the event the underwriters of the issuer's initial public offering do not exercise in full their over-allotment option as described in the issuer's registration statement. Mr. Venkataraman, the Chief Executive Officer and a director of the issuer, is the manager of Avego Healthcare Capital, LLC, which is a managing member of the Sponsor and shares the voting and dispositive power of the securities held by the Sponsor. Accordingly, each of Mr. Venkataraman and Avego Healthcare Capital, LLC may be deemed to share beneficial ownership of such shares. Each of Mr. Venkataraman and Avego Healthcare Capital, LLC, disclaims any beneficial ownership of the reported shares other than to the extent of any pecuniary interest they may have therein, directly or indirectly.
As described in the issuer's registration statement on Form S-1 (File No. 333-234324) under the heading "Description of Securities--Founder Shares", the shares of Class B common stock will automatically convert into shares of Class A common stock at the time of the issuer's initial business combination on a one-for-one basis, subject to certain adjustments described therein and have no expiration date.
/s/ Bala Venkataraman
2019-11-19