0000899243-18-031008.txt : 20181214
0000899243-18-031008.hdr.sgml : 20181214
20181214114524
ACCESSION NUMBER: 0000899243-18-031008
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181213
FILED AS OF DATE: 20181214
DATE AS OF CHANGE: 20181214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: McLaughlin William E III
CENTRAL INDEX KEY: 0001693498
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-10093
FILM NUMBER: 181234949
MAIL ADDRESS:
STREET 1: 1565 NORTH CENTRAL EXPRESSWAY, 2ND FLOOR
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
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-12-13
0
0000319016
Fuse Medical, Inc.
FZMD
0001693498
McLaughlin William E III
2717 NIGHTHAWK DRIVE
PLANO
TX
75025
1
1
0
0
Chief Financial Officer
Common Stock
2018-12-13
4
A
0
222223
0.45
A
475723
D
On December 13, 2018 the Reporting Person was granted 222,223 shares (the "Shares") of the restricted common stock, par value $0.01 per share (the "Common Stock"), of Fuse Medical, Inc. (the "Company") pursuant to the 2017 Equity Incentive Plan of Fuse Medical, Inc. (the "2017 Plan") (incorporated by reference to Exhibit 99.2 of the Issuer's Form 8-K filed with the Securities and Exchange Commisssion (the "SEC") on April 6, 2017 (File No. 000-100093)), subject to the terms and conditions in the 2017 Plan and the form of Restricted Stock Award Agreement (incorporated by reference to Exhibit 10.2 to the Issuer's Form 8-K filed with the SEC on October 10, 2017 (File NO. 000-100093)).
(Continued From Footnote 1) The Shares will vest and cease to be subject to forfeiture upon (a) the occurrence of one of the following events (each, an "Accelerating Event"): (i) a Change in Control (as defined in the 2017 Plan), (ii) the Reporting Person's Termination of Continuous Service (as defined in the 2017 Plan), or (iii) the listing of the Common Stock on either the New York Stock Exchange or the NASDAQ Stock Market; and (b) the delivery by the Reporting Person to the Company of a Notice of Acceleration of Vesting, no later than sixty (60) days following the earlier of (i) the date the Company sends written notice of such Accelerating Event or (ii) the date the Reporting Person actually or constructively becomes aware that such Accelerating Event has occurred.
/s/ William E. McLaughlin, III
2018-12-13