0001209191-19-025273.txt : 20190418 0001209191-19-025273.hdr.sgml : 20190418 20190418181711 ACCESSION NUMBER: 0001209191-19-025273 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190405 FILED AS OF DATE: 20190418 DATE AS OF CHANGE: 20190418 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: 001-38445 FILM NUMBER: 19756819 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: 364787690 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 642 NEWTOWN YARDLEY ROAD CITY: NEWTOWN STATE: PA ZIP: 18940 BUSINESS PHONE: 215-944-6104 MAIL ADDRESS: STREET 1: 642 NEWTOWN YARDLEY ROAD CITY: NEWTOWN STATE: PA ZIP: 18940 FORMER COMPANY: FORMER CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC DATE OF NAME CHANGE: 20180517 FORMER COMPANY: FORMER CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC. DATE OF NAME CHANGE: 20140613 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-04-05 0 0001610853 HELIUS MEDICAL TECHNOLOGIES, INC. HSDT 0001638231 Deschamps Philippe C/O HELIUS MEDICAL TECHNOLOGIES, INC. 642 NEWTOWN YARDLEY ROAD, SUITE 100 NEWTOWN PA 18940 1 1 0 0 President and CEO Class A Common Stock 2019-04-05 4 M 0 5018 5.60 A 15995 D Class A Common Stock 666911 I By LLC Warrant (Right to Buy) 5.60 2019-04-05 4 M 0 5018 0.00 D 2016-04-18 2019-04-18 Class A Common Stock 5018 0 D These securities are directly held by Deschamps Global Healthcare Commercialization LLC (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. Translated into U.S. dollars from Canadian dollars based on the noon buying rate from the Federal Reserve Bank of USD$1.00=CAD$1.3387 on April 5, 2019. The exercise price of the Warrant was CAD $7.50. Effective January 22, 2018, the Issuer effected a 1-for-5 reverse stock split of the Issuer's Class A Common Stock. All share numbers and the exercise price of the Warrant reported herein give effect to the Reverse Stock Split. /s/ Philippe Deschamps 2019-04-18