0001683168-23-006684.txt : 20230925 0001683168-23-006684.hdr.sgml : 20230925 20230925182626 ACCESSION NUMBER: 0001683168-23-006684 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230921 FILED AS OF DATE: 20230925 DATE AS OF CHANGE: 20230925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gumulka Jerzy CENTRAL INDEX KEY: 0001793252 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39126 FILM NUMBER: 231276850 MAIL ADDRESS: STREET 1: C/O CNS PHARMACEUTICALS, INC. STREET 2: 2100 WEST LOOP SOUTH STE 900 CITY: HOUSTON STATE: TX ZIP: 77027 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CNS Pharmaceuticals, Inc. CENTRAL INDEX KEY: 0001729427 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 822318545 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2100 WEST LOOP SOUTH STREET 2: SUITE 900 CITY: HOUSTON STATE: TX ZIP: 77027 BUSINESS PHONE: 1-800-946-9185 MAIL ADDRESS: STREET 1: 2100 WEST LOOP SOUTH STREET 2: SUITE 900 CITY: HOUSTON STATE: TX ZIP: 77027 4 1 ownership.xml X0508 4 2023-09-21 0 0001729427 CNS Pharmaceuticals, Inc. CNSP 0001793252 Gumulka Jerzy C/O CNS PHARMACEUTICALS, INC. 100 WEST LOOP SOUTH, SUITE 900 HOUSTON TX 77027 1 0 0 0 0 Option to purchase common stock 1.09 2023-09-21 4 A 0 68961 A 2033-09-22 Common Stock 68961 74914 D The stock options set forth in this table vest on the earlier of the one-year anniversary of the date of issuance or the date of the 2024 annual meeting, subject to the grantee's continued service to the Company on the vesting date. The stock options were issued in connection with the reporting person's Board of Director services to the Company. /s/ Christopher Downs, Attorney-in-Fact 2023-09-25