0001104659-12-006066.txt : 20120202
0001104659-12-006066.hdr.sgml : 20120202
20120202095455
ACCESSION NUMBER: 0001104659-12-006066
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111117
FILED AS OF DATE: 20120202
DATE AS OF CHANGE: 20120202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chafoulias Gus A
CENTRAL INDEX KEY: 0001346641
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-31275
FILM NUMBER: 12564657
MAIL ADDRESS:
STREET 1: 121 23RD AVENUE SW
CITY: ROCHESTER
STATE: MN
ZIP: 55902
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: VERTICAL HEALTH SOLUTIONS INC
CENTRAL INDEX KEY: 0001163332
STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047]
IRS NUMBER: 593635262
STATE OF INCORPORATION: FL
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7760 FRANCE AVE SOUTH
STREET 2: 11TH FLOOR
CITY: MINNEAPOLIS
STATE: MN
ZIP: 55435
BUSINESS PHONE: 612-568-4210
MAIL ADDRESS:
STREET 1: 7760 FRANCE AVE SOUTH
STREET 2: 11TH FLOOR
CITY: MINNEAPOLIS
STATE: MN
ZIP: 55435
4
1
a4.xml
4
X0304
4
2011-11-17
0
0001163332
VERTICAL HEALTH SOLUTIONS INC
ONMD
0001346641
Chafoulias Gus A
C/O VERTICAL HEALTH SOLUTIONS, INC.
7760 FRANCE AVENUE SOUTH, 11TH FLOOR
MINNEAPOLIS
MN
55435
1
0
0
0
Common Stock, par value $0.001 per share
2011-11-17
4
P
0
10000
A
870000
D
Common Stock Warrant (right to buy)
2.00
2011-11-17
4
P
0
5000
A
2011-11-17
2016-11-17
Common Stock, $0.001 par value
5000
5000
D
The reported securities are included within 10,000 Units purchased by the reporting person for $1.00 per Unit. Each Unit consists of one share of common stock and one warrant to purchase 0.5 shares of common stock.
/s/ William Cavanaugh (attorney-in-fact)
2012-02-02