4: Statement of changes in beneficial ownership of securities
Published on October 29, 2019
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owners
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sim Kenneth T. 1668 S. GARFIELD AVE., 2ND FL. ALHAMBRA, CA 91801 |
X | Executive Chairman and Co-CEO |
Signatures
/s/ by Omar Dabuni as attorney-in- fact for Kenneth Sim, M.D. | 10/29/2019 | |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | These 5,000 shares were acquired inadvertently without the knowledge of the Reporting Person. The Reporting Person placed an order with a broker for the purchase of 5,000 shares at $15.55 on August 22, 2019, which could not be filled at that time given the market price on that date. The Reporting Person believed that the order was cancelled. However, the broker treated the order as remaining open and the above purchase was executed by the broker on October 8, 2019 without the Reporting Person's knowledge. |
(2) | Excludes the Reporting Person's indirect ownership of common stock of Apollo Medical Holdings, Inc. as a shareholder of Allied Physicians of California, A Professional Medical Corporation. |
(3) | These 5,000 shares are owned directly by the Kenneth T. Sim Pension Plan Trust U.A. dated 12/18/2007. The Reporting Person disclaims beneficial ownership of these 5,000 shares except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these 5,000 shares for the purposes of Section 16 or for any other purpose. |