0000899243-18-003239.txt : 20180208 0000899243-18-003239.hdr.sgml : 20180208 20180208134354 ACCESSION NUMBER: 0000899243-18-003239 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171214 FILED AS OF DATE: 20180208 DATE AS OF CHANGE: 20180208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brooks Mark W CENTRAL INDEX KEY: 0001688048 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-10093 FILM NUMBER: 18584825 MAIL ADDRESS: STREET 1: 1565 NORTH CENTRAL EXPRESSWAY, SUITE 200 CITY: RICHARDSON STATE: TX ZIP: 75080 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 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2017-12-14 2017-12-20 0 0000319016 Fuse Medical, Inc. FZMD 0001688048 Brooks Mark W 2615 SIR GAWAIN LANE LEWISVILLE TX 75056 1 0 1 0 Common Stock 2017-12-14 4 A 0 188500 0.20 A 253500 D This Form 4/A amends the number of beneficially-owned securities, directly held by the Reporting Person following the reported transaction, to clarify the actual ownership of such securities and the nature of such ownership. /s/ Mark W. Brooks 2018-01-26