Augmedix (AUGX) Form 4 Change in insider ownership

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

DCM VI, L.P.

(Last) (First) (Middle)

2420 SAND HILL ROAD

SUITE 200

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
Augmedix, Inc. [ NONE ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
10/05/2020

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Common Stock	10/05/2020		A		3,064,751	A	(1)	3,064,751	D(2)
Common Stock	10/05/2020		P		666,667	A	$3	3,731,418	D(2)
Common Stock	10/05/2020		A		20,007	A	(1)	20,007	I	See footnote(3)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Warrant (right to buy)	$2.88	10/05/2020		A		269,490		(4)	09/02/2029	Common Stock	269,490	(1)	269,490	D(2)

1. Name and Address of Reporting Person^*

DCM VI, L.P.

(Last) (First) (Middle)

2420 SAND HILL ROAD

SUITE 200

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

A-Fund, L.P.

(Last) (First) (Middle)

2420 SAND HILL ROAD

SUITE 200

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

Explanation of Responses:

1. On October 5, 2020, the Issuer's wholly-owned subsidiary, August Acquisition Corp. ("Acquisition Sub"), merged with and into Augmedix, Inc., a privately held Delaware corporation ("Augmedix"). Pursuant to this transaction (the "Merger"), Augmedix was the surviving corporation and became the Issuer's wholly owned subsidiary. All of the outstanding shares of stock of Augmedix held by accredited investors were converted into shares of the Issuer's common stock. All of the outstanding warrants, options and stock appreciation rights of Augmedix were assumed by the Issuer.

2. These securities are held of record by DCM VI, L.P. ("DCM VI"). Jason Krikorian, a member of the Issuer's board of directors, is a general partner at DCM, which is an affiliate of DCM VI.

3. These securities are held of record by A-Fund, L.P. ("A-Fund"). Jason Krikorian, a member of the Issuer's board of directors, is a general partner at DCM, which is an affiliate of A-Fund.

4. The warrants are fully vested and exerciseable.

Remarks:

	DCM VI, L.P. By /s/ Matthew Bonner, Chief Operating Officer & Legal Partner A-FUND, L.P. By /s/ Matthew Bonner, Chief Operating Officer & Legal Partner	10/07/2020
	** Signature of Reporting Person	Date
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