-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, WNEu4adD/0tOgDWiScAqnSnEWZTh+070xYKqxsiHZysv9yFRE4wdcBqVGx/DlLsH FxhG6KknkKM45yD0CO6sCQ== 0001144204-10-020817.txt : 20100416 0001144204-10-020817.hdr.sgml : 20100416 20100416145701 ACCESSION NUMBER: 0001144204-10-020817 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090826 FILED AS OF DATE: 20100416 DATE AS OF CHANGE: 20100416 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CNS RESPONSE, INC. CENTRAL INDEX KEY: 0000822370 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 870419387 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 85 ENTERPRISE STREET 2: SUITE 410, CITY: ALISO VIEJO STATE: CA ZIP: 92656 BUSINESS PHONE: (714) 545 3288 MAIL ADDRESS: STREET 1: 85 ENTERPRISE STREET 2: SUITE 410, CITY: ALISO VIEJO STATE: CA ZIP: 92656 FORMER COMPANY: FORMER CONFORMED NAME: STRATIVATION, INC. DATE OF NAME CHANGE: 20051115 FORMER COMPANY: FORMER CONFORMED NAME: SalesTactix, Inc. DATE OF NAME CHANGE: 20040805 FORMER COMPANY: FORMER CONFORMED NAME: AGE RESEARCH INC DATE OF NAME CHANGE: 19990210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PAPPAJOHN JOHN CENTRAL INDEX KEY: 0000897464 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-26285 FILM NUMBER: 10754524 MAIL ADDRESS: STREET 1: 1660 WALT WHITMAN ROAD STREET 2: SUITE 105 CITY: MELVILLE STATE: NY ZIP: 11747 4/A 1 v181276_ex.xml X0303 4/A 2009-08-26 2009-08-31 0 0000822370 CNS RESPONSE, INC. CNSO.OB 0000897464 PAPPAJOHN JOHN 666 WALNUT STREET, SUITE 2116 DES MOINES IA 50309 1 0 1 0 Common Stock Warrant (Right to Buy) 0.30 2009-08-26 4 P 0 1666667 0 A 2009-08-26 2014-08-26 Common Stock 1666667 1666667 D This Amendment to Form 4 is being filed to correct the reported number of shares of Common Stock underlying the Common Stock Warrant issued to Mr. Pappajohn in connection with the August 26, 2009 closing of the Issuer's private placement. The number of shares of Common Stock underlying such warrant was previously reported as 666,667, an amount that was reported as not including Warrants to purchase an aggregate of 1,000,000 shares of Common Stock gifted for no consideration at the time of issuance to certain relatives of Mr. Pappajohn. This amount offsets an amount that was over-reported on Mr. Pappajohn's Form 3 filed on June 22, 2009. /s/ John Pappajohn 2010-04-16 -----END PRIVACY-ENHANCED MESSAGE-----