Statement of Changes in Beneficial Ownership (4)
March 06 2023 - 06:15PM
Edgar (US Regulatory)
FORM 4
[ ] Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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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1. Name
and Address of Reporting Person * Murdock Hunter R. |
2. Issuer Name and Ticker or Trading
Symbol Axsome Therapeutics, Inc. [ AXSM ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
General Counsel |
(Last)
(First)
(Middle)
C/O AXSOME THERAPEUTICS, INC., 22 CORTLANDT ST, 16TH
FLOOR |
3. Date of Earliest Transaction (MM/DD/YYYY)
3/2/2023
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(Street)
NEW YORK, NY 10007
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. 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 |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: 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) |
$65.32 |
3/2/2023 |
|
A |
|
29773 |
|
(1) |
3/1/2033 |
Common Stock |
29773 |
$0.00 |
29773 |
D |
|
Restricted Stock Units |
(2) |
3/2/2023 |
|
A |
|
16883 |
|
(3) |
(3) |
Common Stock |
16883 |
$0.00 |
16883 |
D |
|
Explanation of
Responses: |
(1) |
The option will vest in
substantially equal quarterly installments over four years such
that the option will be fully vested on March 2, 2027. |
(2) |
Each restricted stock unit
("RSU") represents a contingent right to receive one share of the
Issuer's common stock. |
(3) |
25% of the RSUs will vest on
the one (1) year anniversary of the date of grant. The remaining
RSUs will vest in in three substantially equal annual installments,
such that the RSUs will be fully vested on March 2, 2027. Vested
shares will be delivered to the reporting person upon the earlier
of (i) the closing of a Change in Control (as defined in the
Issuer's Amended and Restated 2015 Omnibus Incentive Compensation
Plan (the "Plan"), (ii) the reporting person's separation of
service from the Issuer (including termination with or without
Cause (as defined in the Plan), or termination due to death or
disability), or (iii) seven (7) years from the date of
grant. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Murdock Hunter R.
C/O AXSOME THERAPEUTICS, INC.
22 CORTLANDT ST, 16TH FLOOR
NEW YORK, NY 10007 |
|
|
General Counsel |
|
Signatures
|
/s/ Hunter Murdock |
|
3/6/2023 |
**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. |
Persons who respond to the collection of information
contained in this form are not required to respond unless the form
displays a currently valid OMB control number. |
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