0001209191-21-066287.txt : 20211123 0001209191-21-066287.hdr.sgml : 20211123 20211123073009 ACCESSION NUMBER: 0001209191-21-066287 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211119 FILED AS OF DATE: 20211123 DATE AS OF CHANGE: 20211123 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: 211434679 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 2021-11-19 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 Common Stock 2021-11-19 4 P 0 3950 37.3038 A 120756 D Common Stock 46912 I GRAT Represents additional shares held indirectly by the Reporting Person prior to November 19, 2021. /s/ Roger Jeffs 2021-11-23