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