0001213900-22-016225.txt : 20220330 0001213900-22-016225.hdr.sgml : 20220330 20220330165719 ACCESSION NUMBER: 0001213900-22-016225 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211001 FILED AS OF DATE: 20220330 DATE AS OF CHANGE: 20220330 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kukekov Nickolay V. CENTRAL INDEX KEY: 0001827573 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56216 FILM NUMBER: 22787310 MAIL ADDRESS: STREET 1: 4524 WESTWAY AVE CITY: DALLAS STATE: TX ZIP: 75205 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 1 ownership.xml X0306 4 2021-10-01 0 0001662382 BRAIN SCIENTIFIC INC. BRSF 0001827573 Kukekov Nickolay V. C/O BRAIN SCIENTIFIC INC. 125 WILBUR PLACE, SUITE 170 BOHEMIA NY 11716 1 0 0 0 Options to Purchase Shares of Common Stock 0.35 2021-10-01 4 A 0 2001873 0 A 2021-10-01 2031-10-01 Common Stock 2001873 2001873 D The stock options were issued to Mr. Kukekov pursuant to a Non-Qualified Stock Option Agreement. The stock options are fully vested and exercisable and shall expire on 10/01/2031. /s/ Nickolay Kukekov 2022-03-30