0001596771-21-000006.txt : 20210129 0001596771-21-000006.hdr.sgml : 20210129 20210129165925 ACCESSION NUMBER: 0001596771-21-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210127 FILED AS OF DATE: 20210129 DATE AS OF CHANGE: 20210129 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mertens Steve CENTRAL INDEX KEY: 0001772652 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54716 FILM NUMBER: 21572081 MAIL ADDRESS: STREET 1: 10901 RED CIRCLE DR. STREET 2: SUITE 150 CITY: MINNETONKA STATE: MN ZIP: 55343 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 2021-01-27 0 0001500198 NEUROONE MEDICAL TECHNOLOGIES Corp NMTC 0001772652 Mertens Steve 7599 ANAGRAM DR. EDEN PRAIRIE MN 55344 0 1 0 0 Chief Technology Officer Option to Purchase Common Stock 1.99 2021-01-27 4 A 0 70000 0 A 2031-01-27 Common Stock 70000 70000 D 25% will vest on January 27, 2022 and the remaining 75% will vest in 36 equal monthly installments on the last day of each month beginning on February 28, 2022. /s/ Stephanie Swan, by Power of Attorney 2021-01-29