SEC Form 4/A · accession 0000899243-17-029304
Fuse Medical, Inc. · FZMD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Renato V. Bosita Jr.
Director
Period of report
Sep 21, 2017
Accepted (ET)
Dec 20, 2017 · 3:49 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000319016
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Sep 21, 2017 | A | 65,000 | $0.20 | A | 65,000 | D | |
| Common StockF2 | Sep 21, 2017 | A | 1,000,000 | $0.20 | A | 1,065,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1This Form 4/A amends the price of the Issuer's common stock, par value $0.01 ("Common Stock"), on the original Form 4 filed on 10/10/2017. In consultation with a valuation firm, the Issuer's board of directors determined that at the time of the Reporting Person's acquisition, the Common Stock's fair market value was $0.20 per share.
- F2In consultation with a valuation firm, the Issuer's board of directors determined that at the time of the Reporting Person's acquisition, the Common Stock's fair market value was $0.20 per share.