0001104659-20-139275.txt : 20201223
0001104659-20-139275.hdr.sgml : 20201223
20201223180854
ACCESSION NUMBER: 0001104659-20-139275
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200317
FILED AS OF DATE: 20201223
DATE AS OF CHANGE: 20201223
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jacobson Mark L.
CENTRAL INDEX KEY: 0001805812
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37635
FILM NUMBER: 201413851
MAIL ADDRESS:
STREET 1: 200 BROADWAY
STREET 2: 3RD FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10038
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/A
1
tm2039202-2_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4/A
2020-03-17
2020-03-19
0
0001579428
Axsome Therapeutics, Inc.
AXSM
0001805812
Jacobson Mark L.
C/O AXSOME THERAPEUTICS, INC.
22 CORTLANDT STREET, 16TH FLOOR
NEW YORK
NY
10007
0
1
0
0
Chief Operating Officer
Employee Stock Option (Right to Buy)
45.14
2020-03-17
4
A
0
48237
0
A
2030-03-16
Common Stock
48237
48237
D
Restricted Stock Units
2020-03-17
4
A
0
14767
0
A
Common Stock
14767
14767
D
The option will vest in substantially equal quarterly installments over four years such that the option will be fully vested on March 17, 2024.
Each restricted stock unit ("RSU") represents a contingent right to receive one share of the Issuer's common stock.
25% of the RSUs will vest on the one (1) year anniversary of the date of grant. The remaining RSUs will vest in in three substantially equal annual installments, such that the RSUs will be fully vested on March 17, 2024. Vested shares will be delivered to the reporting person upon the earlier of (i) the closing of a Change in Control (as defined in the Issuer's 2015 Omnibus Incentive Compensation Plan (the "Plan"), (ii) the reporting person's separation of service from the Issuer (including termination with or without Cause (as defined in the Plan), or termination due to death or disability), or (iii) seven (7) years from the date of grant.
Due to an administrative error, the Form 4 originally filed on March 19, 2020 (the "Original Form 4") misstated the number of options and RSUs granted to the reporting person. This amended Form 4 is being filed to amend and restate the Original Form 4 solely to reflect the correct number of options and RSUs. No other changes are being made to the Original Form 4.
/s/ Mark Jacobson
2020-12-23