SEC Form 5 · accession 0001477932-16-008566
Fuse Medical, Inc. · FZMD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert H Donehew
Officer — President · Director
Period of report
Dec 31, 2015
Accepted (ET)
Feb 12, 2016 · 4:15 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 StockF2 | Aug 27, 2015 | A | 250,000 | $0.00 | A | 346,199 | D | |
| Common Stock | holding | — | — | — | 6,840 | I | By Partnership | |
| Common StockF1 | holding | — | — | — | 9,803 | I | By LLC | |
| Common StockF1 | holding | — | — | — | 4,660 | I | By LLC |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The reporting person is one of the managers of the Limited Liability Company.
- F2Not applicable.