0001717370-19-000002.txt : 20191030
0001717370-19-000002.hdr.sgml : 20191030
20191030150024
ACCESSION NUMBER: 0001717370-19-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191028
FILED AS OF DATE: 20191030
DATE AS OF CHANGE: 20191030
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: 001-38861
FILM NUMBER: 191179594
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
2019-10-28
0
0001642375
Guardion Health Sciences, Inc.
GHSI
0001717370
Evans David W
4141 JUTLAND DRIVE, SUITE 215
SAN DIEGO
CA
92117
1
1
0
0
Chief Science Officer
Common Stock
2019-10-30
4
A
0
2000
0.332
A
1544500
D
Warrant
0.342
2019-10-30
4
A
0
2000
0.01
A
2024-10-30
Common Stock
2000
2000
D
Reporting Person purchased 2,000 Series B warrants in Issuer's follow-on public offering, which closed on October 30, 2019, which warrant will become exercisable only after the Issuer effectuates an amendment to its Charter to either (i) increase the number of authorized shares of common stock or (ii) implement a reverse stock split with respect to the shares of common stock. The Series B warrants will then be exercisable any time up to the date that is five years after the Charter Amendment is effectuated.
/s/ Vincent J. Roth as attorney-in-fact for David W. Evans
2019-10-30