0000899243-18-003235.txt : 20180208 0000899243-18-003235.hdr.sgml : 20180208 20180208133734 ACCESSION NUMBER: 0000899243-18-003235 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161219 FILED AS OF DATE: 20180208 DATE AS OF CHANGE: 20180208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Reeg Christopher C CENTRAL INDEX KEY: 0001688080 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-10093 FILM NUMBER: 18584796 MAIL ADDRESS: STREET 1: 3024 WESTMINSTER AVE CITY: DALLAS STATE: TX ZIP: 75205 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fuse Medical, Inc. CENTRAL INDEX KEY: 0000319016 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 591224913 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1565 NORTH CENTRAL EXPRESSWAY STREET 2: SUITE 220 CITY: RICHARDSON STATE: TX ZIP: 75080 BUSINESS PHONE: 469-862-3030 MAIL ADDRESS: STREET 1: 1565 NORTH CENTRAL EXPRESSWAY STREET 2: SUITE 220 CITY: RICHARDSON STATE: TX ZIP: 75080 FORMER COMPANY: FORMER CONFORMED NAME: GOLF ROUNDS COM INC DATE OF NAME CHANGE: 19991126 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN METALS SERVICE INC DATE OF NAME CHANGE: 19920703 3/A 1 doc3a.xml FORM 3/A SUBMISSION X0206 3/A 2016-12-19 2016-12-29 0 0000319016 Fuse Medical, Inc. FZMD 0001688080 Reeg Christopher C 3024 WESTMINSTER AVENUE DALLAS TX 75205 1 1 1 0 Chief Executive Officer Common Stock 4000000 I By Reeg Medical Industries, Inc. Amended and Restated Promissory Note 0.08 2017-01-16 Common Stock 650000 I By Reeg Medical Industries, Inc. These securities are directly owned by Reeg Medical Industries, Inc. ("RMI"), a Texas corporation. Christopher C. Reeg is the sole shareholder, sole director, and sole officer of RMI. Accordingly, Christopher C. Reeg indirectly beneficially owns the reported securities. The Amended and Restated Promissory Note, dated October 19, 2016, made by the Issuer and payable to the order of RMI, in the principal amount of $50,000 ("Note") became payable upon demand on December 19, 2016, and will be convertible into shares of common stock of the Issuer on or after January 16, 2017. The Note does not provide for a stated expiration date. On or after January 16, 2017, RMI will have the right to convert all or any portion of the then unpaid principal and interest balance of the Note into shares of common stock of the Issuer at a conversion price of $0.08 per share. The number of shares reported in box 3 is based on the application of such conversion rate to the amount of principal and interest that will be outstanding on January 16, 2017, if the Note remains outstanding on such date. /s/ Christopher C. Reeg 2018-01-26