Filing Details

Accession Number:
0000899243-18-003228
Form Type:
4/A
Zero Holdings:
No
Publication Time:
2018-02-08 13:30:04
Reporting Period:
2016-12-19
Accepted Time:
2018-02-08 13:30:04
Original Submission Date:
2016-12-29
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
319016 Fuse Medical Inc. FZMD Wholesale-Medical, Dental & Hospital Equipment & Supplies (5047) 591224913
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1688048 W Mark Brooks 2615 Sir Gawain Lane
Lewisville TX 75056
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2016-12-19 5,000,000 $0.08 5,000,000 No 4 P Indirect By NC 143 Family Holdings, LP
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect By NC 143 Family Holdings, LP
Footnotes
  1. These 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.