0001213900-20-031426.txt : 20201015 0001213900-20-031426.hdr.sgml : 20201015 20201015133123 ACCESSION NUMBER: 0001213900-20-031426 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201015 FILED AS OF DATE: 20201015 DATE AS OF CHANGE: 20201015 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Goldstein Boris CENTRAL INDEX KEY: 0001443248 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56216 FILM NUMBER: 201241169 MAIL ADDRESS: STREET 1: 45 WEST34 ST. 800 CITY: NEW YORK STATE: NY ZIP: 10001 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BRAIN SCIENTIFIC INC. CENTRAL INDEX KEY: 0001662382 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 810876714 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 125 WILBUR PLACE, SUITE 170 CITY: BOHEMIA STATE: NY ZIP: 11716 BUSINESS PHONE: (646) 388-3788 MAIL ADDRESS: STREET 1: 125 WILBUR PLACE, SUITE 170 CITY: BOHEMIA STATE: NY ZIP: 11716 FORMER COMPANY: FORMER CONFORMED NAME: All Soft Gels Inc DATE OF NAME CHANGE: 20151229 3 1 ownership.xml X0206 3 2020-10-15 0 0001662382 BRAIN SCIENTIFIC INC. BRSF 0001443248 Goldstein Boris C/O BRAIN SCIENTIFIC INC. 125 WILBUR PLACE, SUITE 170 BOHEMIA NY 11716 1 1 1 0 Chairman of the Board & EVP Common Stock, par value $0.001 per share 328125 D Common Stock, par value $0.001 per share 337450 I By wife Common Stock, par value $0.001 per share 6749000 I By High Technology Capital Fund LP Employee Stock Options (right to buy) 0.75 2029-01-14 Common Stock, par value $0.001 per share 800000 D Employee Stock Options (right to buy) 0.75 2030-01-30 Common Stock, par value $0.001 per share 800000 D The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. The reporting person is the manager of High Technology Capital Management LLC (the "LLC"), the general partner of High Technology Capital Fund LP (the "LP"). As the manager of the LLC, the reporting person has voting and dispositive control over the shares owned by the LP. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. The options vest over a 24-month period as follows: 25% (or 200,000) shall vest six months after the grant date of January 14, 2019, with the remaining options vesting on a monthly basis at a rate of 1/24th per month. The options vest over a 24-month period after the grant date of January 30, 2020, on a monthly basis at a rate of 1/24th per month. /s/ Boris Goldstein 2020-10-15