0001209191-17-067260.txt : 20171226
0001209191-17-067260.hdr.sgml : 20171226
20171226173209
ACCESSION NUMBER: 0001209191-17-067260
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171222
FILED AS OF DATE: 20171226
DATE AS OF CHANGE: 20171226
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Deschamps Philippe
CENTRAL INDEX KEY: 0001638231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55364
FILM NUMBER: 171274972
MAIL ADDRESS:
STREET 1: HELIUS MEDICAL TECHNOLOGIES, INC.
STREET 2: SUITE 400, 41 UNIVERSITY DRIVE
CITY: NEWTOWN
STATE: PA
ZIP: 18940
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: 1231
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-12-22
0
0001610853
HELIUS MEDICAL TECHNOLOGIES, INC.
HSDT
0001638231
Deschamps Philippe
HELIUS MEDICAL TECHNOLOGIES, INC.
642 NEWTOWN YARDLEY ROAD, SUITE 100
NEWTOWN
PA
18940
1
1
0
0
President and CEO
Class A Common Stock
2017-12-22
4
P
0
127551
1.96
A
3334556
I
By LLC
Class A Common Stock
54886
D
Warrant (Right to Buy)
2.45
2017-12-22
4
P
0
127551
1.96
A
2020-12-22
Class A Common Stock
127551
127551
I
By LLC
These securities were purchased by Deschamps Global Healthcare Commercialization LLC (the "LLC"). The Reporting Person is the sole member of the LLC.
The Class A Common Stock and the Warrant to Purchase Class A Common Stock was purchased by the Reporting Person in a private placement as a Unit. The purchase price of the Unit was $1.96.
Represents shares directly held by the LLC and includes shares previously held directly by MPJ Healthcare, LLC ("MPJ"). The Reporting Person is a member of MPJ and is the sole member of the LLC.
Immediately exercisable.
/s/ Philippe Deschamps
2017-12-26