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