0000899243-18-029696.txt : 20181127 0000899243-18-029696.hdr.sgml : 20181127 20181127185633 ACCESSION NUMBER: 0000899243-18-029696 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180801 FILED AS OF DATE: 20181127 DATE AS OF CHANGE: 20181127 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Reeg Christopher C CENTRAL INDEX KEY: 0001688080 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-10093 FILM NUMBER: 181203913 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 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2018-08-01 2018-08-03 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 2018-08-01 4 P 0 2539474 0.76 A 6539474 I By Reeg Medical Industries, Inc. Common Stock 2018-10-04 4 P 0 72139 0.68 A 6611613 I By Reeg Medical Industries, Inc. This Form 4/A amends the Form 4 filed by Christopher C. Reeg ("Reeg") on August 3, 2018, to correct the number of shares of common stock, par value $0.01 (the "Common Stock"), of the Fuse Medical, Inc., a Delaware corporation (the "Company"), that Reeg received pursuant to that certain Securities Purchase Agreement, dated July 30, 2018 (the "Maxim Purchase Agreement"), by and between the Company, Palm Springs Partners, LLC d/b/a Maxim Surgical, a Texas limited liability company ("Maxim"), Reeg Medical Industries, Inc., a Texas corporation ("RMI"), Mr. Amir David Tahernia, an individual ("Tahernia", together with RMI, the "Sellers"), and Tahernia in his capacity as the representative of the Sellers (the "Sellers Representative"). (Continued from Footnote 1) The Company made a calculation error when computing the number of shares of Common Stock issued to RMI, and corrected the number in its Current Report on Form 8-K/A filed with the Securities and Exchange Commission (the "SEC") on November 16, 2018 (the "Maxim Form 8-K/A"). On October 4, 2018, the Company issued 72,139 shares of Common Stock to RMI, which represents RMI's pro rata share of the agreed-upon purchase price adjustment pursuant to Pursuant to the Maxim Purchase Agreement, as reported in the Maxim Form 8-K/A. These securities are directly owned by RMI. Reeg is the sole shareholder, sole director, and sole officer of RMI. Accordingly, Reeg indirectly beneficially owns the reported securities. /s/ Christopher C. Reeg 2018-11-27