4//SEC Filing
CNS RESPONSE, INC. 4
Accession 0001615774-15-002578
$EMMACIK 0000822370operating
Filed
Sep 15, 8:00 PM ET
Accepted
Sep 16, 5:16 PM ET
Size
9.4 KB
Accession
0001615774-15-002578
Insider Transaction Report
Form 4
FOLLMAN ROBERT J
Director10% Owner
Transactions
- Award
5% Secured Convertible Note due March 2016
2015-09-15(indirect: By Trust)Exercise: $0.05From: 2016-03-06Exp: 2016-03-21→ Common Stock (3,000,000 underlying) - Award
5% Secured Convertible Note due March 2016
2015-09-14(indirect: By Trust)Exercise: $0.05From: 2016-03-06Exp: 2016-03-21→ Common Stock (2,000,000 underlying)
Footnotes (5)
- [F1]On September 14, 2015, the Issuer and the holders of the 5% Secured Convertible Notes due March 2016 (the "Notes") entered into an Omnibus Amendment to fix the conversion price of the Notes at $0.05 per share. The Omnibus Amendment amended the Notes and the September 22, 2014 Note Purchase Agreement, as amended, pursuant to which the Notes were issued.
- [F2]The Notes are convertible into shares of common stock either: (i) voluntarily, beginning 15 days prior to the March 21, 2016 maturity date of the Notes (the "Maturity Date"), by the holder or (ii) automatically, if, prior to the Maturity Date, the Issuer consummates a Qualified Financing (as defined in the Notes).
- [F3]The Maturity Date of the Notes is March 21, 2016.
- [F4]The number of derivate securities beneficially owned does not include interest accrued at 5% per annum on the Notes.
- [F5]The Notes are held in the Declaration of Trust of Robert J. Follman and Carole A. Follman, dated August 14, 1979 of which Mr. Follman is a trustee
Documents
Issuer
CNS RESPONSE, INC.
CIK 0000822370
Entity typeoperating
IncorporatedDE
Related Parties
1- filerCIK 0000822370
Filing Metadata
- Form type
- 4
- Filed
- Sep 15, 8:00 PM ET
- Accepted
- Sep 16, 5:16 PM ET
- Size
- 9.4 KB