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