SEC Form 4 · accession 0001104659-15-081134
Axsome Therapeutics, Inc. · AXSM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Constance Ames
Officer — Vice President, Finance
Period of report
Nov 24, 2015
Accepted (ET)
Nov 24, 2015 · 4:26 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001579428
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Nov 24, 2015 | C | 4,358 | $5.94 | A | 4,358 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 8% Convertible NoteF1 | $5.94 | Nov 24, 2015 | A | 4,358 | A | — | Jun 16, 2015 | Common Stock | 4,358 | 0 | D |
Explanation of responses
- F1Consists of an 8% Convertible Note with a principal balance of $25,000 and interest accrued through November 24, 2015 of $888.