SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Smith Robin L

(Last) (First) (Middle)
C/O MYND ANALYTICS, INC.
26522 LA ALAMEDA, SUITE 290

(Street)
MISSION VIEJO CA 92691

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MYnd Analytics, Inc. [ MYND ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/04/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 04/04/2018(1) A 25,000 A $0 148,026 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) $1.55 04/04/2018(2) A 75,000 (2) 04/04/2028 Common Stock 75,000 $0 75,000 D
Employee Stock Option (right to buy) $1.99 04/16/2018(3) A 150,000 (3) 04/16/2028 Common Stock 150,000 $0 150,000 D
Explanation of Responses:
1. The award of Common Stock was granted, and approved by the board of directors of MYnd Analytics, Inc. (the "Registrant"), subject to stockholder approval of amendments to the Registrant's Amended and Restated 2012 Omnibus Incentive Compensation Plan (the "Plan"), pursuant to that certain Chairman Services Agreement (the "Agreement"), dated July 14, 2017 (the "Effective Date"), by and between the reporting person and the Registrant. The Registrant's stockholders approved the amendments to the Plan on April 4, 2018 and the grant vested immediately The registrant agreed to pay the associated taxes, federal and state for this award.
2. The award was granted, and approved by the board of directors of the Registrant, subject to stockholder approval of amendments to the Registrant's Amended and Restated 2012 Omnibus Incentive Compensation Plan (the "Plan"), pursuant to the Agreement. The Registrant's stockholders approved the amendments to the Plan on April 4, 2018. The option vests in three equal installments as follows: 1/3 on the Effective Date, 1/3 on the six-month anniversary of the Effective Date and 1/3 on the twelve-month anniversary of the Effective Date.
3. The award was granted and approved by the board of directors on April 16, 2018. The option vests in three equal installments as follows: 1/3 on the Effective Date, 1/3 on the six-month anniversary of the Effective Date and 1/3 on the twelve-month anniversary of the Effective Date.
/s/ Robin L. Smith 04/20/2018
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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