0001012975-15-000368.txt : 20150514 0001012975-15-000368.hdr.sgml : 20150514 20150514141001 ACCESSION NUMBER: 0001012975-15-000368 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20150514 FILED AS OF DATE: 20150514 DATE AS OF CHANGE: 20150514 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC. CENTRAL INDEX KEY: 0001610853 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 000000000 STATE OF INCORPORATION: WY FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: SUITE 400, 41 UNIVERSITY DRIVE CITY: NEWTOWN STATE: PA ZIP: 18940 BUSINESS PHONE: 215-809-2018 MAIL ADDRESS: STREET 1: SUITE 400, 41 UNIVERSITY DRIVE CITY: NEWTOWN STATE: PA ZIP: 18940 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Deschamps Philippe CENTRAL INDEX KEY: 0001638231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55364 FILM NUMBER: 15861988 MAIL ADDRESS: STREET 1: HELIUS MEDICAL TECHNOLOGIES, INC. STREET 2: SUITE 400, 41 UNIVERSITY DRIVE CITY: NEWTOWN STATE: PA ZIP: 18940 3 1 edgar.xml PRIMARY DOCUMENT X0206 3 2015-05-14 0 0001610853 HELIUS MEDICAL TECHNOLOGIES, INC. HSDT 0001638231 Deschamps Philippe HELIUS MEDICAL TECHNOLOGIES, INC. SUITE 400, 41 UNIVERSITY DRIVE NEWTOWN PA 18940 1 1 0 0 President and CEO Class A Common Stock, Without Par Value 4700 D Class A Common Stock, Without Par Value 3207005.2 I See footnote Stock Option (Right to Buy) .50 2019-06-18 Class A Common Stock 1800000 D Represents shares directly held by MPJ Healthcare, LLC ("MPJ"). The Reporting Person is a member of MPJ. One-third of the shares subject to this option vested on June 19, 2014 and the remaining shares will vest in equal amounts on each of June 19, 2015 and June 19, 2016. Translated into U.S. dollars from Canadian dollars based on the noon buying rate from the Federal Reserve Bank of USD$1.00 = CAD$1.2086 on May 8, 2015, based on an option exercise price of CAD$0.60. Remarks: Exhibit 24 - Power of Attorney Charles Lee, Attorney-in-Fact 2015-05-14 EX-24 2 poadeschamps.htm

    LIMITED POWER OF ATTORNEY FOR

    SECTION 16 REPORTING PURPOSES



  Know all by these presents, that the undersigned hereby makes, constitutes and appoints each of Amanda Tseng, Trevor Chaplick, Frank Zarb, Charles Lee, Stephanie Denzel and Andrew Aitchison, acting individually, as the undersigned's true and lawful attorney-in-fact, with full power and authority as hereinafter described on behalf of and in the name, place and stead of the undersigned to:



  (1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Helius Medical Technologies, Inc. (the "Company"), Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules and regulations promulgated thereunder, as amended from time to time (the "Exchange Act");



  (2) seek or obtain, as the undersigned's representative and on the undersigned's behalf, information on transactions in the Company's securities from any third party, including brokers, employee benefit plan administrators and trustees, and the undersigned hereby authorizes any such person to release any such information to any attorney-in-fact and further approves and ratifies any such release of information;



  (3) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to prepare, complete and execute any such Form 3, 4 or 5, and any amendments thereto, and timely file such Forms with the United States Securities and Exchange Commission and any stock exchange or similar authority as considered necessary or advisable under Section 16(a) of the Exchange Act; and



  (4) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's sole discretion.



  The undersigned hereby gives and grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.



  The undersigned hereby acknowledges that (a) the foregoing attorneys-in-fact are serving in such capacity at the request of the undersigned; (b) this Limited Power of Attorney authorizes, but does not require, each such attorney-in-fact to act in their discretion on information provided to such attorney-in-fact without independent verification of such information; (c) any documents prepared and/or executed by any attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such information and disclosure as such attorney-in-fact, in his or her sole discretion, deems necessary or advisable; (d) neither the Company nor any attorney-in-fact assumes (i) any liability for the undersigned's responsibility to comply with the requirements of the Exchange Act, (ii) any liability of the undersigned for any failure to comply with such requirements, or (iii) any obligation or liability of the undersigned for profit disgorgement under Section 16(b) of the Exchange Act; and (e) this Limited Power of Attorney does not relieve the undersigned from responsibility for compliance with the undersigned's obligations under the Exchange Act, including, without limitation, the reporting requirements under Section 16 of the Exchange Act.



  This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of, and transactions in, securities issued by the Company, unless earlier revoked as to any attorney-in-fact by the undersigned in a signed writing delivered to such attorney-in-fact.



  IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this _____ day of March, 2015.





      /s/ Philippe Deschamps

      Philippe Deschamps