0001582015-21-000005.txt : 20210624 0001582015-21-000005.hdr.sgml : 20210624 20210624160841 ACCESSION NUMBER: 0001582015-21-000005 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210622 FILED AS OF DATE: 20210624 DATE AS OF CHANGE: 20210624 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AYOTTE NEIL P CENTRAL INDEX KEY: 0001582015 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 211042923 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Nuwellis, Inc. CENTRAL INDEX KEY: 0001506492 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 680533453 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 952-345-4200 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 FORMER COMPANY: FORMER CONFORMED NAME: CHF Solutions, Inc. DATE OF NAME CHANGE: 20170523 FORMER COMPANY: FORMER CONFORMED NAME: Sunshine Heart, Inc. DATE OF NAME CHANGE: 20101124 4/A 1 primary_doc.xml PRIMARY DOCUMENT X0306 4/A 2021-06-22 2021-06-23 0 0001506492 Nuwellis, Inc. NUWE 0001582015 AYOTTE NEIL P 12988 VALLEY VIEW ROAD EDEN PRAIRIE MN 55344 0 1 0 0 SVP, Secretary, GC & CCO Non-Qualified Stock Option (right to buy) 3.98 2021-06-22 4 A 0 41690 0 A 2031-06-21 Common Stock 41690 41690 D This amendment is being filed to correct the title of the option, which is a non-qualified stock option rather than an incentive stock option as originally reported. The options will vest as follows: 25% of the options will vest on the one-year anniversary of the date of grant; the remaining options will vest in 36 equal consecutive monthly increments thereafter, so all will be vested on the four-year anniversary of the date of grant. /s/ Neil P. Ayotte 2021-06-24