0001209191-21-038954.txt : 20210608 0001209191-21-038954.hdr.sgml : 20210608 20210608165213 ACCESSION NUMBER: 0001209191-21-038954 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210604 FILED AS OF DATE: 20210608 DATE AS OF CHANGE: 20210608 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: 211002727 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 2021-06-04 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) 61.32 2021-06-04 4 A 0 7325 0.00 A 2022-06-04 2031-06-04 Common Stock 7325 7325 D The option vests in full on the one-year anniversary of the date of grant, June 4, 2022. /S/ Herriot Tabuteau, M.D., Attorney-in-Fact 2021-06-08