0001209191-21-070723.txt : 20211221
0001209191-21-070723.hdr.sgml : 20211221
20211221081508
ACCESSION NUMBER: 0001209191-21-070723
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211217
FILED AS OF DATE: 20211221
DATE AS OF CHANGE: 20211221
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: 211506895
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
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-12-17
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
Class A Common Stock
2021-12-17
4
P
0
1275
5.2528
A
19200
I
See footnote
Class A Common Stock
2021-12-17
4
P
0
3825
5.2528
A
53779
I
See footnote
Class A Common Stock
86482
I
See footnote
Class A Common Stock
4634
I
See footnote
Class A Common Stock
1508
D
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 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 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.
/s/ Dane C. Andreeff
2021-12-21