0001140361-22-006126.txt : 20220218
0001140361-22-006126.hdr.sgml : 20220218
20220218090207
ACCESSION NUMBER: 0001140361-22-006126
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211210
FILED AS OF DATE: 20220218
DATE AS OF CHANGE: 20220218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kotob Hassan
CENTRAL INDEX KEY: 0001890341
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-56216
FILM NUMBER: 22651004
MAIL ADDRESS:
STREET 1: 125 WILBUR PLACE, SUITE 170
STREET 2: C/O BRAIN SCIENTIFIC INC.
CITY: BOHEMIA
STATE: NY
ZIP: 11716
FORMER NAME:
FORMER CONFORMED NAME: kotob Hassan
DATE OF NAME CHANGE: 20211025
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: 6700 PROFESSIONAL PARKWAY
CITY: LAKEWOOD RANCH
STATE: FL
ZIP: 34240
BUSINESS PHONE: (646) 388-3788
MAIL ADDRESS:
STREET 1: 6700 PROFESSIONAL PARKWAY
CITY: LAKEWOOD RANCH
STATE: FL
ZIP: 34240
FORMER COMPANY:
FORMER CONFORMED NAME: All Soft Gels Inc
DATE OF NAME CHANGE: 20151229
4/A
1
form4.xml
FORM 4/A
X0306
4/A
2021-12-10
2021-12-15
0001662382
BRAIN SCIENTIFIC INC.
BRSF
0001890341
Kotob Hassan
C/O BRAIN SCIENTIFIC INC.
6700 PROFESSIONAL PARKWAY
LAKEWOOD RANCH
FL
34240
true
true
true
Chief Executive Officer
Stock Option (right to buy)
0.39
2021-12-10
4
D
0
1218248
D
2031-10-21
Common Stock
1218248
0
D
Stock Option (right to buy)
0.21
2021-12-10
4
A
0
1218248
A
2031-10-21
Common Stock
1218248
1218248
D
The reporting person agreed to an amendment to an outstanding option granted to him on October 21, 2021, which resulted in the deemed disposition of the old option in exchange for a new option having a lower exercise price.
The shares underlying this option vest as to 25% on 4/21/2022, with the remainder vesting in 18 equal monthly installments thereafter, beginning on 5/21/2022 and ending on 10/21/2023.
The shares underlying this option vest in four equal quarterly installments beginning on 3/31/2022 and ending on 12/31/2022.
This amended Form 4 is being filed to add the amendment to the outstanding option as described herein.
/s/ Hassan Kotob
2022-02-18