0001596771-20-000046.txt : 20200604 0001596771-20-000046.hdr.sgml : 20200604 20200604171712 ACCESSION NUMBER: 0001596771-20-000046 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200602 FILED AS OF DATE: 20200604 DATE AS OF CHANGE: 20200604 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BUCKMAN PAUL CENTRAL INDEX KEY: 0001215243 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54716 FILM NUMBER: 20943720 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW RD CITY: EDEN PRAIRIE STATE: MN ZIP: 55402 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NEUROONE MEDICAL TECHNOLOGIES Corp CENTRAL INDEX KEY: 0001500198 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 270863354 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 7599 ANAGRAM DR CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: (952) 426-1383 MAIL ADDRESS: STREET 1: 7599 ANAGRAM DR CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 FORMER COMPANY: FORMER CONFORMED NAME: Original Source Entertainment, Inc. DATE OF NAME CHANGE: 20100830 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2020-06-02 0 0001500198 NEUROONE MEDICAL TECHNOLOGIES Corp NMTC 0001215243 BUCKMAN PAUL 7599 ANAGRAM DRIVE EDEN PRAIRIE MN 55344 1 0 0 0 Common Stock 2020-06-02 4 A 0 22371 0 A 80495 D Option to Purchase Common Stock 1.48 2020-06-02 4 A 0 23725 0 A 2030-06-02 Common Stock 23725 23725 D Represents a grant of restricted stock units, which vest in 12 equal monthly installments over a one-year period, with such vesting to occur at the end of each month. The option vests in 12 equal monthly installments over a one-year period, with such vesting to occur at the end of each month. /s/ Stephanie Swan, by Power of Attorney 2020-06-04