0001567619-20-011105.txt : 20200522
0001567619-20-011105.hdr.sgml : 20200522
20200522203335
ACCESSION NUMBER: 0001567619-20-011105
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200520
FILED AS OF DATE: 20200522
DATE AS OF CHANGE: 20200522
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WALLER GREGORY D
CENTRAL INDEX KEY: 0001204144
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35312
FILM NUMBER: 20907713
MAIL ADDRESS:
STREET 1: 1717 W COLLINS AVENUE
CITY: ORANGE
STATE: CA
ZIP: 92867
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CHF Solutions, Inc.
CENTRAL INDEX KEY: 0001506492
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 680533453
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 12988 VALLEY VIEW ROAD
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
BUSINESS PHONE: 952-345-4200
MAIL ADDRESS:
STREET 1: 12988 VALLEY VIEW ROAD
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
FORMER COMPANY:
FORMER CONFORMED NAME: Sunshine Heart, Inc.
DATE OF NAME CHANGE: 20101124
4
1
doc1.xml
FORM 4
X0306
4
2020-05-20
0
0001506492
CHF Solutions, Inc.
CHFS
0001204144
WALLER GREGORY D
12988 VALLEY VIEW ROAD
EDEN PRAIRIE
MN
55344
1
0
0
0
Nonstatutory Stock Option
0.35
2020-05-20
4
A
0
18849
0.00
A
2030-05-19
Common Stock
18849
18849
D
Vests in 12 approximately equal consecutive monthly increments, commencing on the one-month anniversary of the date of grant, so that all of the options will be vested on the one-year anniversary of the date of grant.
Claudia Drayton, By Power of Attorney
2020-05-22