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