0001104659-22-100051.txt : 20220914
0001104659-22-100051.hdr.sgml : 20220914
20220914163829
ACCESSION NUMBER: 0001104659-22-100051
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220912
FILED AS OF DATE: 20220914
DATE AS OF CHANGE: 20220914
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ANDREEFF DANE
CENTRAL INDEX KEY: 0001201810
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38445
FILM NUMBER: 221243437
MAIL ADDRESS:
STREET 1: C/O ANDREEFF EQUITY ADVISORS L.L.C.
STREET 2: 140 E. ST. LUCIA LANE
CITY: SANTA ROSA BEACH
STATE: FL
ZIP: 32459
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HELIUS MEDICAL TECHNOLOGIES, INC.
CENTRAL INDEX KEY: 0001610853
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 364787690
STATE OF INCORPORATION: DE
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
tm2225892-3_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2022-09-12
0
0001610853
HELIUS MEDICAL TECHNOLOGIES, INC.
HSDT
0001201810
ANDREEFF DANE
C/O HELIUS MEDICAL TECHNOLOGIES, INC.
642 NEWTOWN YARDLEY ROAD, SUITE 100
NEWTOWN
PA
18940
1
1
1
0
President and CEO
Common Stock
2022-09-12
4
P
0
4752
0.5444
A
144819
I
See footnote
Common Stock
2022-09-12
4
P
0
1014
0.5444
A
31645
I
See footnote
Common Stock
2022-09-12
4
P
0
2838
0.5444
A
88618
I
See footnote
Common Stock
2022-09-12
4
P
0
264
0.5444
A
7881
I
See footnote
Common Stock
2022-09-13
4
P
0
150000
0.5347
A
238618
I
See footnote
Common Stock
1508
D
Stock Option (Right to Buy)
0.54
2022-09-13
4
A
0
86000
0
A
2032-09-12
Common Stock
86000
86000
D
The shares are held by Maple Leaf Partners, L.P. ("MLP"). The reporting person is the managing member of Maple Leaf Capital I, LLC ("Maple Leaf Capital"), the general partner of MLP and as such may be deemed to beneficially own the securities owned by MLP. The reporting person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the reported shares for purposes of Section 16 or for any other purposes.
The shares are held by Maple Leaf Partners I, L.P. ("MLP I"). The reporting person is the managing member of Maple Leaf Capital, the general partner of MLP I and as such may be deemed to beneficially own the securities owned by MLP I. The reporting person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the reported shares for purposes of Section 16 or for any other purposes.
The shares are held by Maple Leaf Discovery I, L.P. ("MLD I"). The reporting person is the managing member of Maple Leaf Capital, the general partner of MLD I and as such may be deemed to beneficially own the securities owned by MLD I. The reporting person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the reported shares for purposes of Section 16 or for any other purposes.
The shares are held by Maple Leaf Offshore Ltd. ("MLO"). The reporting person is the president of the managing member of Andreeff Equity Advisors, L.L.C., the investment manager of MLO and as such may be deemed to beneficially own the securities owned by MLO. The reporting person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the reported shares for purposes of Section 16 or for any other purposes.
Grant to the Reporting Person of a stock option under the Issuer's 2022 Equity Incentive Plan. The options vest in a series of twelve (12) successive equal quarterly installments on the last day of each quarter so that all of the options will be vested on the three-year anniversary of the grant date, subject to the Reporting Person's continued service through each applicable vesting period.
/s/ Dane Andreeff
2022-09-14