0001596771-17-000053.txt : 20170606 0001596771-17-000053.hdr.sgml : 20170606 20170606164812 ACCESSION NUMBER: 0001596771-17-000053 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170602 FILED AS OF DATE: 20170606 DATE AS OF CHANGE: 20170606 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 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: 17894665 MAIL ADDRESS: STREET 1: 1717 W COLLINS AVENUE CITY: ORANGE STATE: CA ZIP: 92867 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-06-02 0 0001506492 CHF Solutions, Inc. CHFS 0001204144 WALLER GREGORY D 12988 VALLEY VIEW ROAD EDEN PRAIRIE MN 55344 1 0 0 0 Non-Qualified Stock Option (right to buy) 0.57 2017-06-02 4 A 0 8000 0 A 2027-06-01 Common Stock 8000 8000 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. Gayle C. Aiken, by Power of Attorney 2017-06-06