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