0001709738-23-000013.txt : 20231113 0001709738-23-000013.hdr.sgml : 20231113 20231113174327 ACCESSION NUMBER: 0001709738-23-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231109 FILED AS OF DATE: 20231113 DATE AS OF CHANGE: 20231113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Christianson Mark CENTRAL INDEX KEY: 0001709738 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40439 FILM NUMBER: 231400359 MAIL ADDRESS: STREET 1: 10006 LIATRIS LANE CITY: EDEN PRAIRIE STATE: MN ZIP: 55347 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 X0508 4 2023-11-09 0 0001500198 NEUROONE MEDICAL TECHNOLOGIES Corp NMTC 0001709738 Christianson Mark 7599 ANAGRAM DRIVE EDEN PRAIRIE MN 55344 0 1 0 0 Business Development Director 0 Option to Purchase Common Stock 1.25 2023-11-09 4 A 0 17688 0 A 2033-11-08 Common Stock 17688 17688 D 25% will vest on November 9, 2024, and the remaining 75% will vest in 36 equal monthly installments on the last day of each month following November 9, 2024. /s/ Stephanie Swan, by Power of Attorney 2023-11-13