SEC Form 4/A · accession 0000899243-18-003228
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
Mark W Brooks
Director · 10% Owner
Period of report
Dec 19, 2016
Accepted (ET)
Feb 8, 2018 · 1:30 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 | Dec 19, 2016 | P | 5,000,000 | $0.08 | A | 5,000,000 | I | By NC 143 Family Holdings, LP |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These securities are directly owned by NC 143 Family Holdings, LP ("NC 143"), a Texas limited partnership, however both the Medtech Family Trust dated October 1, 2014 ("Medtech"), and NC 143 Family Holdings GP LLC ("GP") indirectly own the reported securities. Medtech is the sole manager of the GP, and the GP is the sole general partner of NC 143. Accordingly, both Medtech and the GP indirectly beneficially own the reported securities.