0001567619-19-018268.txt : 20190913 0001567619-19-018268.hdr.sgml : 20190913 20190913163040 ACCESSION NUMBER: 0001567619-19-018268 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190903 FILED AS OF DATE: 20190913 DATE AS OF CHANGE: 20190913 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Costanzo Maria Rosa CENTRAL INDEX KEY: 0001788278 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 191092897 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 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 3 1 doc1.xml FORM 3 X0206 3 2019-09-03 0 0001506492 CHF Solutions, Inc. CHFS 0001788278 Costanzo Maria Rosa 12988 VALLEY VIEW ROAD EDEN PRAIRIE MN 55344 1 0 0 0 Common Stock 0 D Thomas Lynch, By Power of Attorney 2019-09-13 EX-24.1 2 poa_constanzo.htm
Power of Attorney
For Section 16(a) Securities and Exchange Act of 1934 Filings

Know all by these presents, that the undersigned hereby constitutes and appoints each of Thomas Lynch, Claudia Drayton and Paul Wotta signing singly, the undersigned’s true and lawful attorney-in- fact to:


 (1)
Do and perform all acts for and on behalf the undersigned, solely in the undersigned’s capacity as an officer and/or director of CHF Solutions, Inc. (the “Company”), which may be necessary or desirable to apply for, obtain and/or maintain EDGAR Access Codes to be used on behalf of the undersigned for Electronic Filing of all Section 16(a) Securities and Exchange Act of 1934 filings;


(2)
Execute for and on behalf of the undersigned, solely in the undersigned’s capacity as an officer and/or director of the Company, Forms 3, 4, and 5 and any amendments thereto in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;


(3)
Do and perform any and all acts for and on behalf of the undersigned, solely in the undersigned’s capacity as an officer and/or director of the Company, which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and


(4)
Take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact’s discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned’s holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the 12th day of September 2019.


 Signature:
/s/ Maria Rosa Costanzo

Print Name:
Maria Rosa Costanzo