0001179110-20-004010.txt : 20200319 0001179110-20-004010.hdr.sgml : 20200319 20200319211931 ACCESSION NUMBER: 0001179110-20-004010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200317 FILED AS OF DATE: 20200319 DATE AS OF CHANGE: 20200319 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jacobson Mark L. CENTRAL INDEX KEY: 0001805812 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37635 FILM NUMBER: 20730016 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: 200 BROADWAY, 3RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10038 BUSINESS PHONE: (212) 332-3241 MAIL ADDRESS: STREET 1: 200 BROADWAY, 3RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10038 4 1 edgar.xml FORM 4 - X0306 4 2020-03-17 0 0001579428 Axsome Therapeutics, Inc. AXSM 0001805812 Jacobson Mark L. C/O AXSOME THERAPEUTICS, INC. 200 BROADWAY, 3RD FLOOR NEW YORK NY 10038 0 1 0 0 Chief Operating Officer Employee Stock Option (Right to Buy) 45.14 2020-03-17 4 A 0 60880 0 A 2030-03-16 Common Stock 60880 60880 D Restricted Stock Units 2020-03-17 4 A 0 18645 0 A Common Stock 18645 18645 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. /s/ Mark Jacobson 2020-03-19