0001717370-18-000001.txt : 20180403 0001717370-18-000001.hdr.sgml : 20180403 20180403143515 ACCESSION NUMBER: 0001717370-18-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180329 FILED AS OF DATE: 20180403 DATE AS OF CHANGE: 20180403 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Evans Tamara A CENTRAL INDEX KEY: 0001718289 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55723 FILM NUMBER: 18732787 MAIL ADDRESS: STREET 1: 4141 JUTLAND DRIVE, SUITE 215 CITY: SAN DIEGO STATE: CA ZIP: 92117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Evans David W CENTRAL INDEX KEY: 0001717370 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55723 FILM NUMBER: 18732788 MAIL ADDRESS: STREET 1: 4141 JUTLAND DRIVE, SUITE 215 CITY: SAN DIEGO STATE: CA ZIP: 92117 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: 858-605-9055 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 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2018-03-29 0 0001642375 Guardion Health Sciences, Inc. None 0001717370 Evans David W 4141 JUTLAND DRIVE, SUITE 215 SAN DIEGO CA 92117 1 0 0 0 0001718289 Evans Tamara A 4141 JUTLAND DRIVE, SUITE 215 SAN DIEGO CA 92117 0 0 0 1 Wife of David W. Evans Common Stock 2018-03-31 4 J 0 2742000 0 D 3050000 D Common Stock 2018-03-31 4 J 0 250000 0 D 3050000 D Common Stock 2018-03-31 4 G 0 14000 0 D 3036000 D Common Stock 2018-03-31 4 G 0 14000 0 D 3022000 D Common Stock 2018-03-31 4 G 0 30000 0 A 2992000 D Pursuant to the Asset Purchase and Reorganization Agreement by and among the Issuer, the Issuer's wholly owned subsidiary, VectorVision Ocular Health, Inc., and VectorVision, Inc., VectorVision was required to change its name. In conjunction therewith, VectorVision is transfer its shares to its two shareholders, David W. Evans and Tamara Evans. This transfer is merely a change from indirect ownership through VectorVision to direct ownership by Mr. and Mrs. Evans. Pursuant to the Asset Purchase and Reorganization Agreement by and among the Issuer, the Issuer's wholly owned subsidiary, VectorVision Ocular Health, Inc., and VectorVision, Inc., 250,000 shares are held back until the indemnity period lapses. The shares are represented by a separate certificate. This transfer is merely a change from indirect ownership to direct ownership with the Reporting Persons. Gift of shares to daughter not living in the Reporting Persons' household. The Reporting Persons disclaim beneficial ownership over these shares. Gift of shares to father of Reporting Person, David W. Evans, not living in household. The Reporting Persons disclaim beneficial ownership over these shares. /Vincent J. Roth, attorney-in-fact for David W. Evans/ 2018-04-03 /Vincent J. Roth, attorney-in-fact for Tamara Evans/ 2018-04-03