0001104659-16-124832.txt : 20160601
0001104659-16-124832.hdr.sgml : 20160601
20160601160207
ACCESSION NUMBER: 0001104659-16-124832
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160527
FILED AS OF DATE: 20160601
DATE AS OF CHANGE: 20160601
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Axsome Therapeutics, Inc.
CENTRAL INDEX KEY: 0001579428
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 454241907
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 25 BROADWAY, 9TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10004
BUSINESS PHONE: 212-203-5072
MAIL ADDRESS:
STREET 1: 25 BROADWAY, 9TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10004
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: TABUTEAU HERRIOT
CENTRAL INDEX KEY: 0001219927
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37635
FILM NUMBER: 161689135
4
1
a4.xml
4
X0306
4
2016-05-27
0
0001579428
Axsome Therapeutics, Inc.
AXSM
0001219927
TABUTEAU HERRIOT
25 BROADWAY, 9TH FLOOR
NEW YORK
NY
10004
1
1
1
0
Chief Executive Officer
Employee Stock Option (Right to Buy)
8.02
2016-05-27
4
A
0
524000
0
A
2026-05-26
Common Stock
524000
524000
D
Represents 375,000 options granted as an initial employment grant and 149,000 options granted as an annual grant.
The option will vest in substantially equal quarterly installments such that the option will be fully vested on May 27, 2020.
/s/ Constance Ames, Attorney-in-Fact
2016-06-01