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