0001209191-19-060775.txt : 20191216
0001209191-19-060775.hdr.sgml : 20191216
20191216195708
ACCESSION NUMBER: 0001209191-19-060775
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191207
FILED AS OF DATE: 20191216
DATE AS OF CHANGE: 20191216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Walter Blane
CENTRAL INDEX KEY: 0001340555
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38445
FILM NUMBER: 191288396
MAIL ADDRESS:
STREET 1: 500 OLDE WORTHINGTON ROAD
CITY: WESTERVILLE
STATE: OH
ZIP: 43082
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC.
CENTRAL INDEX KEY: 0001610853
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 364787690
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 642 NEWTOWN YARDLEY ROAD
CITY: NEWTOWN
STATE: PA
ZIP: 18940
BUSINESS PHONE: 215-944-6104
MAIL ADDRESS:
STREET 1: 642 NEWTOWN YARDLEY ROAD
CITY: NEWTOWN
STATE: PA
ZIP: 18940
FORMER COMPANY:
FORMER CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC
DATE OF NAME CHANGE: 20180517
FORMER COMPANY:
FORMER CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC.
DATE OF NAME CHANGE: 20140613
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-12-07
0
0001610853
HELIUS MEDICAL TECHNOLOGIES, INC.
HSDT
0001340555
Walter Blane
C/O HELIUS MEDICAL TECHNOLOGIES, INC.
642 NEWTOWN YARDLEY ROAD, SUITE 100
NEWTOWN
PA
18940
1
0
0
0
Stock Option (Right to Buy)
4.48
2019-12-07
4
D
0
10000
0.00
D
2020-12-31
Class A Common Stock
10000
0
D
Stock Option (Right to Buy)
4.48
2019-12-07
4
A
0
10000
0.00
A
2025-12-31
Class A Common Stock
10000
10000
D
Stock Option (Right to Buy)
5.35
2019-12-07
4
D
0
20000
0.00
D
2020-07-13
Class A Common Stock
20000
0
D
Stock Option (Right to Buy)
5.35
2019-12-07
4
A
0
20000
0.00
A
2026-07-13
Class A Common Stock
20000
20000
D
These two reported transactions involved an amendment of an outstanding option originally granted on December 31, 2015 resulting in the deemed cancellation of the December 31, 2015 option and the grant of a replacement option with the same terms other than the expiration date.
Immediately exercisable.
These two reported transactions involved an amendment of an outstanding option originally granted on July 13, 2016 resulting in the deemed cancellation of the July 13, 2016 option and the grant of a replacement option with the same terms other than the expiration date.
Effective January 22, 2018, the Issuer effected a 1-for-5 reverse stock split of the Issuer's Class A Common Stock. All share numbers herein give effect to the reverse stock split. In addition, all conversion or exercise prices of derivative securities in column 2 of Table II herein are translated into U.S. Dollars from Canadian dollars.
/s/ Joyce LaViscount, Attorney-in-Fact
2019-12-16