0001553350-16-001824.txt : 20160401
0001553350-16-001824.hdr.sgml : 20160401
20160401113844
ACCESSION NUMBER: 0001553350-16-001824
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160330
FILED AS OF DATE: 20160401
DATE AS OF CHANGE: 20160401
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: 0131
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37392
FILM NUMBER: 161545685
MAIL ADDRESS:
STREET 1: 1668 GARFIELD AVE., 2ND FLOOR
CITY: ALHAMBRA
STATE: CA
ZIP: 91801
4
1
lam4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-03-30
0
0001083446
Apollo Medical Holdings, Inc.
AMEH
0001664499
Lam Thomas S.
1668 S. GARFIELD AVENUE
2ND FLOOR
ALHAMBRA
CA
91801
1
0
0
0
Series B Preferred Stock
2016-03-30
4
P
0
555555
9.00
A
2016-03-30
Common Stock
555555
555555
I
By Network Medical Management, Inc.
Warrants to purchase Common Stock
10.00
2016-03-30
4
P
0
555555
9.00
A
2016-03-30
2021-03-30
Common Stock
555555
1666666
I
By Network Medical Management, Inc.
Reporting Party purchased 555,555 investment units at $9.00 per unit. Each investment unit is comprised of (a) one (1) share of Series B Preferred Stock that may be converted into one (1) share of Common Stock, and (b) one (1) warrant to purchase one (1) share of Common Stock at an exercise price of $10.00 per share.
The Series B Preferred Stock is convertible into Common Stock, (a) at the option of the holder thereof at any time after issuance, and (b) mandatorily at any time prior to and including March 31, 2017, 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 B Preferred Stock). The Series B Preferred Stock is convertible into Common Stock at an initial conversion rate of one-for-one, subject to adjustment in the event of stock dividends, stock splits and certain other similar transactions.
These shares are owned directly by Network Medical Management, Inc., 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.
2016-04-01