Amended Statement of Beneficial Ownership (3/a)
June 16 2020 - 4:44PM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
|
1. Name and Address of Reporting Person
*
MATHIESEN JEFFREY S |
2. Date of Event Requiring Statement (MM/DD/YYYY)
6/10/2020
|
3. Issuer Name and Ticker or Trading Symbol
HELIUS MEDICAL TECHNOLOGIES, INC. [HSDT]
|
|
(Last)
(First)
(Middle)
C/O HELIUS MEDICAL TECHNOLOGIES, INC., 642 NEWTOWN YARDLEY ROAD, SUITE 100 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
|
|
(Street)
NEWTOWN, PA 18940
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
6/12/2020
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Beneficially Owned
|
1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Stock Option (Right to Buy) | (1) | 6/9/2030 | Class A Common Stock | 61218 (2) | $0.545 | D | |
| Explanation of Responses: |
| (1) | Grant to the Reporting Person of a stock option under the Issuer's 2018 Omnibus Incentive Plan. The shares vest in a series of twelve (12) successive equal monthly installments measured from June 10, 2020, subject to the Reporting Person's continued service through each applicable vesting date. |
| (2) | This Form 3/A is being filed to amend an inadvertent error in the number of stock options granted to the Reporting Person in the Form 3 previously filed on June 12, 2020. The number of stock options reported on this amendment reflect the correct number of stock options granted to the Reporting Person. |
Reporting Owners
|
| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
MATHIESEN JEFFREY S
C/O HELIUS MEDICAL TECHNOLOGIES, INC.
642 NEWTOWN YARDLEY ROAD, SUITE 100
NEWTOWN, PA 18940 | X |
|
|
|
Signatures
|
| /s/ Philippe Deschamps, Attorney-in-Fact | | 6/16/2020 |
| **Signature of Reporting Person | Date |
Helius Medical Technolog... (NASDAQ:HSDT)
Historical Stock Chart
From Mar 2024 to Apr 2024
Helius Medical Technolog... (NASDAQ:HSDT)
Historical Stock Chart
From Apr 2023 to Apr 2024
