0001685799-16-000005.txt : 20161227 0001685799-16-000005.hdr.sgml : 20161226 20161227134646 ACCESSION NUMBER: 0001685799-16-000005 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161227 FILED AS OF DATE: 20161227 DATE AS OF CHANGE: 20161227 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: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55723 FILM NUMBER: 162070333 MAIL ADDRESS: STREET 1: 15150 AVENUE OF SCIENCE STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 3 1 primary_doc.xml PRIMARY DOCUMENT X0206 3 2016-12-27 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 150000 D Common Stock 100000 D This Restricted Stock Grant was 75% vested as of October 1, 2016 and the remaining 25% is scheduled to vest on January 1, 2017. /s/ Vincent J. Roth 2016-12-27