0001135337-17-000006.txt : 20170103 0001135337-17-000006.hdr.sgml : 20170103 20170103163958 ACCESSION NUMBER: 0001135337-17-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161231 FILED AS OF DATE: 20170103 DATE AS OF CHANGE: 20170103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Guardion Health Sciences, Inc. CENTRAL INDEX KEY: 0001642375 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 474428421 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15150 AVENUE OF SCIENCE, SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 BUSINESS PHONE: 858-605-9055 MAIL ADDRESS: STREET 1: 15150 AVENUE OF SCIENCE, SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 FORMER COMPANY: FORMER CONFORMED NAME: Guardion Health Sciences, LLC DATE OF NAME CHANGE: 20150513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROTH VINCENT J CENTRAL INDEX KEY: 0001137897 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55723 FILM NUMBER: 17502294 MAIL ADDRESS: STREET 1: 15150 AVENUE OF SCIENCE STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2016-12-31 0 0001642375 Guardion Health Sciences, Inc. none 0001137897 ROTH VINCENT J 15150 AVENUE OF SCIENCE SUITE 200 SAN DIEGO CA 92128 0 1 0 0 General Counsel and Secretary Common Stock 2016-12-31 4 A 0 15000 0 A 265000 D Grant of restricted stock for services vesting 50% on June 30, 2017 and 50% on December 31, 2017. Previous 250,000 restricted shares held, 100,000 of which were vesting and fully vested on January 1, 2017. /s/ Vincent J. Roth 2016-01-03