0001596771-19-000051.txt : 20190528 0001596771-19-000051.hdr.sgml : 20190528 20190528165106 ACCESSION NUMBER: 0001596771-19-000051 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190523 FILED AS OF DATE: 20190528 DATE AS OF CHANGE: 20190528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Salveson Jon W CENTRAL INDEX KEY: 0001372026 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 19858427 MAIL ADDRESS: STREET 1: 800 NICOLLET MALL CITY: MINNEAPOLIS STATE: MN ZIP: 55402 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2019-05-23 0 0001506492 CHF Solutions, Inc. CHFS 0001372026 Salveson Jon W 800 NICOLLET MALL MINNEAPOLIS MN 55402 1 0 0 0 Nonstatutory Stock Option (right to buy) 3.42 2019-05-23 4 A 0 1970 0 A 2029-05-22 Common Stock 1970 1970 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. /s/ Phillip D. Torrence, by Power of Attorney 2019-05-28