0001493152-21-021786.txt : 20210901 0001493152-21-021786.hdr.sgml : 20210901 20210901161549 ACCESSION NUMBER: 0001493152-21-021786 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210106 FILED AS OF DATE: 20210901 DATE AS OF CHANGE: 20210901 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Scholtes Bret CENTRAL INDEX KEY: 0001490606 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-38861 FILM NUMBER: 211230217 MAIL ADDRESS: STREET 1: 2105 CITY WEST BLVD. STREET 2: SUITE 500 CITY: HOUSTON STATE: TX ZIP: 77042 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Guardion Health Sciences, Inc. CENTRAL INDEX KEY: 0001642375 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 474428421 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15150 AVENUE OF SCIENCE, SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 BUSINESS PHONE: (800) 873-5141 MAIL ADDRESS: STREET 1: 15150 AVENUE OF SCIENCE, SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92128 FORMER COMPANY: FORMER CONFORMED NAME: Guardion Health Sciences, LLC DATE OF NAME CHANGE: 20150513 4/A 1 ownership.xml X0306 4/A 2021-01-06 2021-01-06 0 0001642375 Guardion Health Sciences, Inc. GHSI 0001490606 Scholtes Bret C/O GUARDION HEALTH SCIENCES, INC. 2925 RICHMOND AVENUE, SUITE 1200 HOUSTON TX 77098 1 1 0 0 Chief Executive Officer Employee Stock Option (right to buy) 0.659 2021-01-06 4 A 0 916023 0 A 2031-01-05 Common Stock 916023 916023 D This Form 4 is being filed to amend, in its entirety, the prior Form 4 filed by the Reporting Person on January 6, 2021 which erroneously indicated the Reporting Person acquired 916,023 shares of the Issuer's common stock through the exercise of an option grant of 916,023 shares of the Issuer's common stock. /s/ Bret Scholtes 2021-09-01