0000899243-21-010804.txt : 20210309 0000899243-21-010804.hdr.sgml : 20210309 20210309214528 ACCESSION NUMBER: 0000899243-21-010804 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210305 FILED AS OF DATE: 20210309 DATE AS OF CHANGE: 20210309 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JEFFS ROGER CENTRAL INDEX KEY: 0001231615 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37635 FILM NUMBER: 21728075 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: 22 CORTLANDT STREET, 16TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10007 BUSINESS PHONE: (212) 332-3241 MAIL ADDRESS: STREET 1: 22 CORTLANDT STREET, 16TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10007 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-03-05 0 0001579428 Axsome Therapeutics, Inc. AXSM 0001231615 JEFFS ROGER C/O AXSOME THERAPEUTICS, INC 22 CORTLANDT STREET, 16TH FLOOR NEW YORK NY 10007 1 0 0 0 Stock Option (Right to Buy) 65.02 2021-03-05 4 A 0 1463 0.00 A 2021-03-05 2031-03-04 Common Stock 1463 1463 D Represents 1,463 options elected to be received in lieu of cash compensation earned in 2020. All of such options are immediately exercisable. /s/ Herriot Tabuteau, M.D., Attorney-in-Fact 2021-03-09