0000899243-22-007416.txt : 20220223
0000899243-22-007416.hdr.sgml : 20220223
20220223173050
ACCESSION NUMBER: 0000899243-22-007416
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220223
DATE AS OF CHANGE: 20220223
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Reeg Christopher C
CENTRAL INDEX KEY: 0001688080
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-10093
FILM NUMBER: 22665190
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
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2021-12-31
0
0
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
2021-11-04
5
A
0
73530
0.68
A
549253
D
Common Stock
6611613
I
Owner of CMI
On November 14, 2021 the Reporting Person was granted 73,530 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 Amended and Restated 2008 Equity Incentive Plan of Fuse Medical Inc. (the "2018 Plan") (incorporated by reference to Exhibit 10.1 of the Issuer's Form 8-K filed with the Securities and Exchange Commission(the "SEC") on December 18, 2018 (File No. 000-100093)), subject to the terms and conditions in the 2018 Plan.
(Continued From Footnote 1) The Shares will vest and cease to be subject to fortfeiture upon (a) the occurrence of one of the following events (each, an "Accelerating Event"): (A) the listing of the Company's Common Stock on either the NYSE or the NASDAQ Stock Market; or (B) a change in Control (as defined in the 2018 Plan); and (ii) the delivery by the Reporting Person to our company of a Notice of Acceleration of Vesting (as defined in award agreement) no later than sixty (60) days following the earlier of (A) the date our Company sends written notice of such Accelerating Event or (B) the date the Reporting Person actually or constructively becomes aware that such Accelerating Event has occurred.
/s/ Christopher C. Reeg
2022-02-14