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