0001209191-20-056817.txt : 20201103
0001209191-20-056817.hdr.sgml : 20201103
20201103212305
ACCESSION NUMBER: 0001209191-20-056817
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201030
FILED AS OF DATE: 20201103
DATE AS OF CHANGE: 20201103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kronfol Amr
CENTRAL INDEX KEY: 0001731772
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39160
FILM NUMBER: 201285041
MAIL ADDRESS:
STREET 1: C/O WARBURG PINCUS LLC
STREET 2: 450 LEXINGTON AVE
CITY: NEW YORK
STATE: NY
ZIP: 10017
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SOC Telemed, Inc.
CENTRAL INDEX KEY: 0001791091
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090]
IRS NUMBER: 843131208
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1768 BUSINESS CENTER DRIVE
STREET 2: SUITE 100
CITY: RESTON
STATE: VA
ZIP: 20190
BUSINESS PHONE: 866-483-9690
MAIL ADDRESS:
STREET 1: 1768 BUSINESS CENTER DRIVE
STREET 2: SUITE 100
CITY: RESTON
STATE: VA
ZIP: 20190
FORMER COMPANY:
FORMER CONFORMED NAME: Healthcare Merger Corp.
DATE OF NAME CHANGE: 20191015
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-10-30
0
0001791091
SOC Telemed, Inc.
TLMD
0001731772
Kronfol Amr
C/O SOC TELEMED, INC.
1768 BUSINESS CENTER DRIVE, SUITE 100
RESTON
VA
20190
1
0
0
0
Common Stock
2020-10-30
4
A
0
33311
A
33311
D
Common Stock
2020-10-30
4
A
0
9628
A
42939
D
Stock Options
2.48
2020-10-30
4
A
0
11039
A
2026-04-26
Common Stock
11039
11039
D
Stock Options
4.95
2020-10-30
4
A
0
4730
A
2026-04-26
Common Stock
4730
4730
D
Stock Options
2.48
2020-10-30
4
A
0
18398
A
2026-04-26
Common Stock
18398
18398
D
Stock Options
4.95
2020-10-30
4
A
0
7885
A
2026-04-26
Common Stock
7885
7885
D
Received in connection with the Issuer's business combination (the "Business Combination") with Specialists On Call, Inc. ("Legacy SOC Telemed") in accordance with the terms of the Agreement and Plan of Merger dated as of July 29, 2020, among the Issuer (f/k/a Healthcare Merger Corp.), Sabre Merger Sub I, Inc., Sabre Merger Sub II, LLC and Legacy SOC Telemed, in exchange for options to acquire 109,124 shares of common stock of Legacy SOC Telemed for $1.00 per share.
Received in connection with the Business Combination in exchange for options to acquire 46,768 shares of common stock of Legacy SOC Telemed for $2.00 per share.
The stock option vested and became exercisable as to 1/5th of the total number of shares on April 26, 2017 and thereafter vested and will continue to vest and become exercisable as to 1/5th of the total number of shares in equal annual installments, subject to the continuous service of the Reporting Person on each vesting date.
Received in connection with the Business Combination in exchange for options to acquire 27,281 shares of common stock of Legacy SOC Telemed for $1.00 per share.
Received in connection with the Business Combination in exchange for options to acquire 11,691 shares of common stock of Legacy SOC Telemed for $2.00 per share.
The stock option will vest and become exercisable in full in the event of a change in control of the Issuer, subject to the continuous service of the Reporting Person on such vesting date.
Received in connection with the Business Combination in exchange for options to acquire 45,468 shares of common stock of Legacy SOC Telemed for $1.00 per share.
Received in connection with the Business Combination in exchange for options to acquire 19,486 shares of common stock of Legacy SOC Telemed for $2.00 per share.
/s/ Eunice Kim, as Attorney-in-Fact
2020-11-03