0001209191-21-055888.txt : 20210914 0001209191-21-055888.hdr.sgml : 20210914 20210914161019 ACCESSION NUMBER: 0001209191-21-055888 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210910 FILED AS OF DATE: 20210914 DATE AS OF CHANGE: 20210914 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BUCKMAN PAUL CENTRAL INDEX KEY: 0001215243 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38445 FILM NUMBER: 211252502 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW RD CITY: EDEN PRAIRIE STATE: MN ZIP: 55402 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 2021-09-10 0 0001610853 HELIUS MEDICAL TECHNOLOGIES, INC. HSDT 0001215243 BUCKMAN PAUL C/O HELIUS MEDICAL TECHNOLOGIES INC. 642 NEWTOWN YARDLEY ROAD SUITE 100 NEWTOWN PA 18940 1 0 0 0 Class A Common Stock 2021-09-10 4 A 0 721 0.00 A 721 D Stock Option (Right to Buy) 14.90 2021-09-10 4 A 0 2547 0.00 A 2031-09-09 Class A Common Stock 2547 2547 D Grant to the Reporting Person of restricted stock units ("RSUs") under the Issuer's 2018 Omnibus Incentive Plan. The RSUs vest in a series of twelve (12) successive equal monthly installments on the last day of each month so that all of the RSUs will be vested on the one-year anniversary of the grant date, subject to the Reporting Person's continued service through each applicable vesting period. Grant to the Reporting Person of a stock option under the Issuer's 2018 Omnibus Incentive Plan. The options vest in a series of twelve (12) successive equal monthly installments on the last day of each month so that all of the options will be vested on the one-year anniversary of the grant date, subject to the Reporting Person's continued service through each applicable vesting period. /s/ Allison Northup, Attorney-in-Fact 2021-09-14