0001104659-22-100061.txt : 20220914
0001104659-22-100061.hdr.sgml : 20220914
20220914164517
ACCESSION NUMBER: 0001104659-22-100061
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220913
FILED AS OF DATE: 20220914
DATE AS OF CHANGE: 20220914
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Favit-Van Pelt Antonella R.
CENTRAL INDEX KEY: 0001871533
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38445
FILM NUMBER: 221243485
MAIL ADDRESS:
STREET 1: C/O HELIUS MEDICAL TECHNOLOGIES, INC.
STREET 2: 642 NEWTOWN YARDLEY ROAD
CITY: NEWTOWN
STATE: PA
ZIP: 18940
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
tm2225892-2_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2022-09-13
0
0001610853
HELIUS MEDICAL TECHNOLOGIES, INC.
HSDT
0001871533
Favit-Van Pelt Antonella R.
C/O HELIUS MEDICAL TECHNOLOGIES, INC.
642 NEWTOWN YARDLEY ROAD, SUITE 100
NEWTOWN
PA
18940
0
1
0
0
Chief Medical Officer
Stock Option (Right to Buy)
0.54
2022-09-13
4
A
0
10000
0
A
2032-09-12
Common Stock
10000
10000
D
Grant to the Reporting Person of a stock option under the Issuer's 2022 Equity Incentive Plan. The options vest in a series of twelve (12) successive equal quarterly installments on the last day of each quarter so that all of the options will be vested on the three-year anniversary of the grant date, subject to the Reporting Person's continued service through each applicable vesting period.
/s/ Emily Johns, by Power of Attorney
2022-09-14