0001209191-19-060778.txt : 20191216
0001209191-19-060778.hdr.sgml : 20191216
20191216195848
ACCESSION NUMBER: 0001209191-19-060778
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191207
FILED AS OF DATE: 20191216
DATE AS OF CHANGE: 20191216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GRIFFIN THOMAS E
CENTRAL INDEX KEY: 0001625114
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38445
FILM NUMBER: 191288401
MAIL ADDRESS:
STREET 1: C/O ENTELLUS MEDICAL, INC.
STREET 2: 3600 HOLLY LANE NORTH, SUITE 40
CITY: PLYMOUTH
STATE: MN
ZIP: 55447
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
2019-12-07
0
0001610853
HELIUS MEDICAL TECHNOLOGIES, INC.
HSDT
0001625114
GRIFFIN THOMAS E
C/O HELIUS MEDICAL TECHNOLOGIES, INC.
642 NEWTOWN YARDLEY ROAD, SUITE 100
NEWTOWN
PA
18940
1
0
0
0
Stock Option (Right to Buy)
4.98
2019-12-07
4
D
0
20000
0.00
D
2020-08-08
Class A Common Stock
20000
0
D
Stock Option (Right to Buy)
4.98
2019-12-07
4
A
0
20000
0.00
A
2026-08-08
Class A Common Stock
20000
20000
D
These two reported transactions involved an amendment of an outstanding option originally granted on August 8, 2016 resulting in the deemed cancellation of the August 8, 2016 option and the grant of a replacement option with the same terms other than the expiration date.
Immediately exercisable.
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 herein give effect to the reverse stock split. In addition, all conversion or exercise prices of derivative securities in column 2 of Table II herein are translated into U.S. Dollars from Canadian dollars.
/s/ Thomas E. Griffin
2019-12-16