0001213900-22-017226.txt : 20220401
0001213900-22-017226.hdr.sgml : 20220401
20220401104525
ACCESSION NUMBER: 0001213900-22-017226
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211210
FILED AS OF DATE: 20220401
DATE AS OF CHANGE: 20220401
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MacKenzie Donald S
CENTRAL INDEX KEY: 0001890325
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-56216
FILM NUMBER: 22796408
MAIL ADDRESS:
STREET 1: 5251 FISHER ISLAND DRIVE
CITY: MIAMI BEACH
STATE: FL
ZIP: 33109
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
2021-12-10
0
0001662382
BRAIN SCIENTIFIC INC.
BRSF
0001890325
MacKenzie Donald S
5251 FISHER ISLAND DRIVE
MIAMI BEACH
FL
33109
1
0
0
0
Options to Purchase Shares of Common Stock
0.29
2022-02-03
4
A
0
362069
0
A
2031-12-11
Common Stock
362069
362069
D
The options were initially issued to Mr. MacKenzie pursuant to a stock option agreement, dated December 10, 2021, whereby Mr. MacKenzie was issued 61,140 options to purchase shares of common stock of the Issuer with an exercise price of $0.21. On February 3, 2022, the Issuer and Mr. MacKenzie entered into an amended stock option agreement (the "Amendment") whereby (i) the number of options issued to Mr. MacKenzie was amended to 362,069, and the exercise price was amended to $0.29. Pursuant to the Amendment, the options shall vest and become exercisable pursuant to the following schedule: 46,623 options vested and became exercisable on December 31, 2021, 89,277 options vested and became exercisable on March 31, 2022; 90,269 options shall become exercisable on June 30, 2022, 91,261 options shall become exercisable on September 30,2022; and 44,639 options shall become exercisable on December 31, 2022.
/s/ Donald MacKenzie
2022-04-01