Chen Carey Form 4 Fathom Digital Manufacturing / Carey Chen ownership change

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^*

Chen Carey

(Last)

(First)

(Middle)

C/O FATHOM DIGITAL MANUFACTURING

CORPORATION, 1050 WALNUT RIDGE DRIVE

(Street)

HARTLAND

53029

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Fathom Digital Manufacturing Corp [ NONE ]

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

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

3. Date of Earliest Transaction (Month/Day/Year)
10/23/2023

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

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

X	Form filed by One Reporting Person
	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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Class A Common Stock⁽¹⁾	10/23/2023		A		151,515	A	⁽¹⁾	225,543⁽²⁾	D
Class A Common Stock⁽³⁾	10/23/2023		A		104,911	A	⁽³⁾	330,454⁽²⁾	D

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)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)

Explanation of Responses:

1. Represents shares of Class A Common Stock underlying Restricted Stock Units ("RSUs") issued to the Reporting Person. Each RSU represents the contingent right to receive one share of the Issuer's Class A Common Stock. These RSUs vest on October 23, 2026, subject to the Reporting Person's continued service through such vesting date.

2. On September 28, 2023, the Class A Common Stock of the Issuer underwent a 1-for-20 reverse stock split (the "Reverse Stock Split"). The amounts of securities listed herein have been adjusted to reflect the effect of the Reverse Stock Split.

3. Represents shares of Class A Common Stock underlying Performance Stock Units ("PSUs") issued to the Reporting Person. Each PSU represents the contingent right to receive one share of the Issuer's Class A Common Stock. The PSUs will vest in six tranches, with each tranche subject to (i) the Company attaining certain stock price growth hurdles during certain performance periods for each tranche, and (ii) Mr. Chen's continued service through the later of (x) the fourth anniversary of October 23, 2023 and (y) the date on which a particular tranche's stock price growth hurdle is attained, subject to certification of the Compensation Committee of the Issuer's Board of Directors.

	/s/ Carey Chen, by Steve Gavin as Attorney-in-Fact	10/25/2023
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.

Chen Carey Form 4Fathom Digital Manufacturing / Carey Chen ownership change