0001788278-20-000001.txt : 20200108
0001788278-20-000001.hdr.sgml : 20200108
20200108150332
ACCESSION NUMBER: 0001788278-20-000001
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190903
FILED AS OF DATE: 20200108
DATE AS OF CHANGE: 20200108
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Costanzo Maria Rosa
CENTRAL INDEX KEY: 0001788278
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35312
FILM NUMBER: 20515513
MAIL ADDRESS:
STREET 1: 12988 VALLEY VIEW ROAD
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CHF Solutions, 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: Sunshine Heart, Inc.
DATE OF NAME CHANGE: 20101124
4/A
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4/A
2019-09-03
2019-09-16
0
0001506492
CHF Solutions, Inc.
CHFS
0001788278
Costanzo Maria Rosa
12988 VALLEY VIEW ROAD
EDEN PRAIRIE
MN
55344
1
0
0
0
Nonstatutory Stock Option
2.46
2019-09-03
4
J
0
1313
0
A
2029-09-02
Common Stock
1313
1313
D
On January 6, 2020, the reporting person rejected the nonstatutory stock options granted to her on September 3, 2019. Accordingly, the reporting person disclaims beneficial ownership of these options of the Issuer's common stock issuable in connection therewith. This report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose.
Vests in 12 approximately equal consecutive monthly increments, commencing on the one-month anniversary of the date of grant, so that all of the options will be vested on the one-year anniversary of the date of grant.
Thomas Lynch, by Power of Attorney
2020-01-08