UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 14A
Proxy Statement Pursuant to Section 14(a) of the Securities
Exchange Act of 1934 (Amendment No. )
Filed by the Registrant o
Filed by a Party other than the Registrant þ
Check the appropriate box:
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Preliminary Proxy Statement |
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Confidential, for Use of the Commission Only (as permitted by Rule 14a-6(e)(2)) |
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Definitive Proxy Statement |
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Definitive Additional Materials |
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Soliciting Material Pursuant to §240.14a-12 |
CNS RESPONSE, INC.
(Name of Registrant as Specified In Its Charter)
Leonard J. Brandt
(Name of Person(s) Filing Proxy Statement, if other than the Registrant)
Payment of Filing Fee (Check the appropriate box):
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No fee required. |
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Fee computed on table below per Exchange Act Rules 14a-6(i)(1) and 0-11. |
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Check box if any part of the fee is offset as provided by Exchange Act Rule 0-11(a)(2)
and identify the filing for which the offsetting fee was paid previously. Identify the
previous filing by registration statement number, or the Form or Schedule and the date of its
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SOLICITATION BY LEONARD J. BRANDT
OF PROXIES OF STOCKHOLDERS
of
CNS RESPONSE, INC.
TO STOCKHOLDERS OF CNS RESPONSE, INC.:
I, Leonard J. Brandt, am soliciting proxies of the stockholders of CNS Response, Inc. to be
used at the Special Meeting of Stockholders being held in lieu of an Annual Meeting, and any
adjournments or postponements thereof (collectively the Special Meeting), to be held on
[Thursday, July 16, 2009]. Proxies are being solicited for the following purposes:
PROPOSAL 1 To elect the following individuals (the Nominees) as directors of CNS
Response, Inc., a Delaware corporation with its principal executive offices located at 2755
Bristol St., Suite 285, Costa Mesa, California 92626 (the Company), to serve until the
next annual meeting and until their successors are elected and qualified.
Leonard J. Brandt
William Murray
Carl Cadwell
Mordechay Yekutiel
Andy Goren
PROPOSAL 2 To set the authorized number of directors at five (5), pending a subsequent
resolution of the stockholders or the Board to change the authorized number.
Sincerely,
/s/ Leonard J. Brandt
Leonard J. Brandt
PLEASE CAREFULLY READ THE ACCOMPANYING PROXY STATEMENT FOR MORE DETAILED INFORMATION. IF YOU
HAVE ANY QUESTIONS OR NEED ADDITIONAL COPIES OF THE PROXY SOLICITATION MATERIALS, PLEASE SUBMIT
YOUR REQUESTS TO LEONARD J. BRANDT AT .
OR BY FAXING A WRITTEN REQUEST TO .
ii
Preliminary Copy
SOLICITATION BY LEONARD J. BRANDT
OF PROXIES OF STOCKHOLDERS OF CNS RESPONSE, INC.
PROXY STATEMENT
GENERAL INFORMATION
The accompanying Proxy is solicited by the Leonard J. Brandt, a stockholder of CNS Response,
Inc. (the Company) to be used at the Special Meeting of Stockholders being held in lieu of an
Annual Meeting, and any adjournments or postponements thereof (collectively the Special Meeting),
to be held on [Thursday July 16, 2009, at 10 A.M.], Eastern Standard Time, at the office of United
Corporate Services, Inc., 874 Walker Road, Suite C, Dover, Delaware 19904. Shares represented by a
valid Proxy (Proxy) will be voted as specified if received in time for the Meeting. If a choice
is not specified in the Proxy, the Proxy will be voted FOR the election of all the director
nominees listed in this Proxy Statement and FOR Proposal 2. The Proxy may be voted in the
discretion of the proxy holders named therein on any other business as may properly come before the
Meeting.
The costs of Proxy solicitation will be paid by Leonard J. Brandt. It is contemplated that
Proxies will be solicited principally through the use of the US Mail, telephone, email and
facsimile transmission. Leonard J. Brandt will reimburse banks, brokerage houses, and other
custodians, nominees or fiduciaries for their reasonable expenses in forwarding proxy material to
the beneficial owners of the shares held by them. The participants may solicit proxies in person
or by telephone, facsimile, email, mail, courier, and delivery services. Leonard J. Brandt intends
to conduct all solicitation activities himself. Neither Leonard J. Brandt nor any of the other
participants intends to conduct any solicitations through any regular employees, specially-engaged
employees or proxy solicitation firms.
[IN DEFINITIVE PROXY ONLY: This Proxy Statement and Proxy are first being mailed to
stockholders on or about July
_____
, 2009.]
Definitive copies of this Proxy Statement when filed with the Securities and Exchange
Commission, are intended to be first sent, given or released to holders of Common Stock on July
_____
,
2009, which is 10 days after the filing of this preliminary Proxy Statement or after such shorter
period prior to that date as the Securities and Exchange Commission may authorize upon a showing of
good cause.
QUORUM; VOTE REQUIRED FOR APPROVAL; EFFECT OF ABSTENTIONS AND VOTES AGAINST
The only outstanding class of stock of the Company having voting rights is the Companys
Common Stock, par value $0.001 per share. Only holders of Common Stock are entitled to vote on the
Proposals. Each share of Common Stock has one vote.
To establish a quorum for the meeting requires the presence at the meeting, in person or by
proxy, of a majority of the outstanding Common Stock. There were
_____
shares of Common Stock
outstanding as of
_____
, 2009 according to . A majority of the
number of shares outstanding would be
_____
shares.
Disapproving or abstaining on a proposal, and brokers indicating a non-vote in any
other manner, all have the same effect ,and none is counted as a vote on any Proposal; however,
each may be considered as present in person or by proxy at the meeting, and therefore, because a
vote against, an abstention or a nonvote may be deemed to indicate presence in person or by proxy
at the meeting, doing so could help establish a quorum for the meeting.
Votes of the holders of a plurality of the shares of Common Stock present or represented at
the meeting are required to approve Proposal 1 in accordance with the Delaware General Corporation
Law.
Votes of the majority of the of the shares of Common Stock present or represented and voting
at the meeting are required to approve Proposal 2 in accordance with the Delaware General
Corporation Law.
If a preference is not indicated on a signed and dated Proxy delivered by any Stockholder, the
Proxy will be counted as FOR each of the Proposals.
RECORD DATE; OUTSTANDING COMMON STOCK
The Record Date for determining the number of shares of Common Stock outstanding shall be July
_____
, 2009, which is [the date prior to the giving of notice of the the meeting] or [a date
determined by the Board of Directors not later than ten days before the date of the meeting].
PROCEDURE TO VOTE
Holders of shares of Common Stock on the Record Date are urged to sign, date and return the
Proxy form to Leonard J. Brandt via fax to or send addressed to him at
.
If your shares of Common Stock are registered in more than one name, the accompanying Proxy
form should be signed by all such persons.
However, if your shares are held in the name of a brokerage firm, bank or nominee, only they
can give a Proxy for your shares, and only upon receipt of your specific instructions.
If your shares are not held in a brokerage account and a stock certificate is registered
in your own name, you are the Stockholder of record. You may print out, sign and date the
Proxy form attached hereto.
On the other hand, if your shares are held in a stock brokerage account or by a bank or
other nominee, you are considered the beneficial owner of shares held in street name, and in
that case these proxy materials are being forwarded to you by your broker who is considered, with
respect to those shares, the Stockholder of record. To sign the Proxy as a beneficial owner, you
may either
A. Direct your broker to sign the Proxy for your shares by sending a written directive to
your broker to do so; OR
B. Specifically request a document called a legal proxy from your broker which you will
sign and date and forward with a signed and dated copy of the Proxy.
IN EITHER CASE, SEND ALL PROXIES TO LEONARD J. BRANDT
.
REVOCABILITY OF PROXIES
Any Proxy given pursuant to this solicitation is considered revocable by the person giving it
at any time before it is used. Any Proxy may be revoked by duly-executing a written notice of
revocation of Proxy or a Proxy bearing a later date and delivering the same to Leonard J. Brandt at
or by fax to if received prior to the Special Meeting.
2
PERSON MAKING THIS SOLICITATION
This solicitation of Proxies is not made by the Company. Leonard J. Brandt is making this
solicitation of Proxies. The only other participants in the solicitation are the Nominees. Please
see PROPOSAL 1, ELECTION OF DIRECTORS, Information With Respect to the Nominees.
The participants may solicit Proxies in person or by telephone, facsimile, email, mail,
courier, and delivery services. Leonard J. Brandt intends to conduct all solicitation activities
himself. Neither Leonard J. Brandt nor any of the other participants intends to conduct any
solicitations through any regular employees, specially-engaged employees or proxy solicitation
firms.
EXPENSES OF SOLICITATION
The entire expense of the solicitation of Proxies will be borne by Leonard J. Brandt. Leonard
J. Brandt currently estimates that the total expenditures for, in furtherance of, or in connection
with the Proxy solicitation will be approximately $50,000. Leonard J. Brandt has incurred
approximately $25,000 of such expenses to date. If any of the Nominees are elected, Leonard J.
Brandt intends to seek reimbursement from the Company for those expenses, but does not intend to
submit the question of such reimbursement to a vote of the stockholders.
PROPOSAL 1
ELECTION OF DIRECTORS
Information With Respect to the Nominees
Listed below are the Nominees, with information showing the principal occupation or employment
of the Nominees, the principal business of the corporation or other organization in which such
occupation or employment is carried on, and such Nominees business experience during the past five
years.
Leonard J. Brandt, age 53, is a director of the Company. He became the Companys Chairman of
the Board, Chief Executive Officer and Secretary upon completion of the Companys merger with CNS
Response, Inc., a California corporation (or CNS California) on March 7, 2007 and served in those
capacities until April 10, 2009. Mr. Brandt was a founder of CNS California, and had served as its
President and Chief Executive Officer, and as a member of its Board of Directors since its
inception in 2000. Mr. Brandt started his career with Norwest Venture Capital in 1980. In 1983 he
became Vice President of Norwest Growth Fund and General Partner of Norwest Venture Partners, where
he served until 1990. In this capacity he was primarily responsible for the firms investments in
the healthcare industry, including several involving the behavioral health industry. In 1995 Mr.
Brandt founded Time Segment Publishing, Inc and was its President until 1999. In 1999, Mr. Brandt
co-founded Embro Vascular, LLC, a provider of technology for least-invasive harvesting of the
saphenous vein for heart-bypass surgery. He also individually provided consulting to early stage
ventures from 1993 until he co-founded Mill City Venture Consulting in 1998. Mill City Venture
Consulting was initially an advisor to NuPharm, Inc., the predecessor of CNS California. Mr.
Brandt holds a Bachelor of Science degree from the College of Commerce at University of Illinois
and a Masters of Business Administration from Harvard University.
William Murray, age
_____
, has over 20 years of experience in the Medical Device and Life Science
areas. He is currently the President and CEO of ReShape Medical, Inc. a development stage company
focused on non-surgical therapies for the treatment of obesity. Prior to ReShape, Bill held various
senior level executive positions, including President of the Molecular Biology Division of Applied
Biosystems (Life Science tools for genetic analysis), Group President Respiratory Technologies at
Viasys Healthcare, and President of the Pacemaker business at Medtronic. In addition to leading the
Pacing Business, Bill was responsible for CRM business development, the EP Systems Business, and
the Functional Diagnostic Business. Prior to running these businesses, he had responsibility for
engineering, development and project management of a number of implantable pacing systems.
Bill holds a BSEE from the University of Florida and has served on the Boards of Zinectics
Medical, Innovatus Ventures and ReShape Medical.
3
Carlton (Carl) Cadwell, age
_____
, cofounded Cadwell Laboratories in 1979 with his brother
John. He has been the President since that time. Cadwell is a leading manufacturer and marketer of
diagnostic and monitoring products for the world of neurophysiology, including EEG,
electromyography, sleep diagnostics and intraoperative monitoring. Distribution is now in 60
countries. Carl also serves on the Board of Directors of Advanced Medical Isotopes (ADMD.PK).
Mordechay Yekutiel, age
_____
, has had as his primary profession of the last 33 years in
commercial real estate operating in CA, TX and NV. His secondary activity has been financial
support and guidance of early stage technology driven companies including, QPC, Inc. a laser
manufacturer with applications in dermatology and other fields, and NuPharm, Inc. the predecessor
technology development company that licensed the basic rEEG technology to CNS Response, Inc.
Andy Goren, age
_____
, has served as Chief Executive Officer for various medical, semiconductor,
and wireless companies. Most recently, Mr. Goren was CEO of BioQ, Inc., a medical device company
pioneering the treatment of gait and balance disorders due to peripheral neuropathy. Prior to his
role at BioQ, Inc., Mr. Goren served as CEO of MobileWise, Inc., a revolutionary wire-free electric
power delivery system. Additionally, Mr. Goren served as CEO of GeePS, Inc., a wireless
location-based services infrastructure provider with operations worldwide. Mr. Goren brings 15
years of industry experience in manufacturing, sales, marketing, business development, fundraising,
and OEM relationships with large global corporations. Mr. Goren obtained his B.S. degree in
Mathematics from the University of California at Berkeley and performed graduate studies in
Neuroscience at Stanford.
SECURITY OWNERSHIP OF THE PARTICIPANTS
The following table sets forth the name and the number of shares of Common Stock of the
Company beneficially owned as of June 26, 2009, by Leonard J. Brandt and each of the Nominees.
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Number of Shares |
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Beneficially Owned |
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Percent of Class (1) |
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Leonard J. Brandt |
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7,934,631 |
(2) |
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28.0 |
% |
William Murray |
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Carl Cadwell |
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600,006 |
(4) |
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Mordechay Yekutiel |
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198,394 |
(5) |
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Andy Goren |
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Total |
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Indicates less than 1%. |
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Calculated as of June 26, 2009 based on the 28,349,171 shares of Common Stock of the Company
believed to be outstanding. |
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Consists of 7,934,631 shares of Common Stock (including 540,000 shares owned by Mr. Brandts
children) held by Mr. Brandt. |
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4
TRANSACTIONS OF THE PARTICIPANTS IN COMPANY SECURITIES
The following table sets forth for Leonard J. Brandt and each of the Nominees their purchases
and sales (indicated in parenthesis) of Common Stock within the previous two years, the dates of
the transactions and the amounts purchased or sold:
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Trade Date |
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Quantity |
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Leonard J. Brandt |
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June 9, 2009 |
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607,900 |
Leonard J. Brandt |
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June 19, 2009 |
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2,124,740 |
William Murray |
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Carl Cadwell |
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Mordechay Yekutiel |
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Andy Goren |
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LEGAL PROCEEDINGS
Neither Leonard J. Brandt not any Nominee is involved in any material pending legal
proceedings with respect to the Company.
INTERESTS OF NOMINEES
If the Nominees are elected to the Board of Directors, Leonard J. Brandt will ask the board to
consider and vote on whether to adopt other changes in management of the Company, whether to
scale-back or change current budgets and spending plans, whether to proceed with current Company
business strategies, whether to proceed with current Company financing strategies that likely will
include sales of securities of the Company, whether to modify current Company plans on these
subjects and whether to adopt alternative plans on these subjects.
Brandt made a loan of $250,000 to the Company with his personal funds, and such loan is
evidenced by a promissory note that may become convertible into securities of the Company in the
event the Company completes an offering and sale of equity securities in a specified minimum
amount. The promissory note is not presently convertible, and the promissory note may not become
convertible at all. The conversion price is unknown and will be based upon the future sales price,
if any, in the qualified offering. At some future time, Brandt may acquire securities of the
Company under the terms of this promissory note.
Brandt intends to participate as an investor in future offerings of the Company.
If elected to the Board of Directors, the Nominees who are non-employee directors may each
receive whatever compensation for their services as directors as may be determined from time to
time.
Leonard J. Brandt also intends to seek reimbursement from the Company for those expenses
incurred by Leonard J. Brandt relating to the Proxy Solicitation, if any Nominees are elected, but
does not intend to submit the question of such reimbursement to a vote of the Stockholders. For an
estimate of those costs, please see the section entitled EXPENSES OF SOLICITATION on page 3.
For information regarding ownership of the Companys stock by the Nominees, including Leonard
J. Brandt, please see SECURITY OWNERSHIP OF THE PARTICIPANTS .
Regarding any purchases and sales of the Companys securities during the past two years by the
participants, please see TRANSACTIONS OF THE PARTICIPANTS IN COMPANY SECURITIES.
5
ARRANGEMENTS OR UNDERSTANDINGS WITH NOMINEES
The Nominees understand that, if elected as Directors of the Company, each of them will have
an obligation under Delaware law to discharge his duties as a Director in good faith, consistent
with his fiduciary duties to the Company and its Stockholders.
There is no arrangement or understanding between any Nominee and any other person pursuant to
which the Nominee was selected as a Nominee.
COMPENSATION BY THE COMPANY OF THE PARTICIPANTS
Summary Compensation Table
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All Other |
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Salary |
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Bonus |
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Option Awards |
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Compensation |
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Year |
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($) |
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($) |
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($) |
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($) |
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Total ($) |
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Leonard J. Brandt |
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2008 |
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175,000 |
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0 |
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0 |
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19,000 |
(4) |
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194,000 |
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(Chief Executive |
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2007 |
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175,000 |
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0 |
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1,025,600 |
(2) |
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18,000 |
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1,218,600 |
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Officer, Principal |
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2006 |
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175,000 |
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10,000 |
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196,500 |
(3) |
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59,700 |
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441,200 |
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Executive Officer,
Director)(1) |
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For the fiscal years ended 2005 and 2006, Mr. Brandt agreed to forgo payment of his salary and
allow CNS California to accrue such compensation. In August 2006, Mr. Brandt agreed to settle his
claims for compensation through September 30, 2006 in the aggregate amount of $1,106,900 in
exchange for the issuance of 298,437 shares of CNS California common stock, which were exchanged
for 298,437 shares of our common stock on March 7, 2007 upon the Companys merger with CNS
California (the Merger). |
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The fair value of options was estimated on the date of grant using the Black-Scholes option
pricing model with the following weighted-average assumptions: grant date fair value of $1.09;
dividend yield of 0; risk free interest rate of 4.72%; expected volatility of 91% and an expected
life of 5 years. |
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Represents options to purchase 2,124,740 shares of Common Stock for which the CNS California
common stock underlying the originally issued options were exchanged upon the closing of the
Merger. The options are fully vested and exercisable at $0.132 per share. The fair value of
options was estimated on the date of grant using the Black-Scholes option pricing model with the
following weighted-average assumptions: grant date fair value of $0.132; dividend yield of 0; risk
free interest rate of 5.5%; expected volatility of 100% and an expected life of 5 years. |
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Relates to healthcare insurance premiums paid on behalf of executive officers by the Company. |
Outstanding Equity Awards at Fiscal Year-End 2008
The following table presents information regarding outstanding options held by the
participants in the solicitation as of the end of the Companys fiscal year ended September 30,
2008. None of the participants exercised options during the fiscal year ended September 30, 2008.
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Number of Securities Underlying |
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Unexercised Options (#) |
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Option Exercise |
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Option Expiration |
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Exercisable |
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Unexercisable |
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Price ($) |
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Date |
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Leonard Brandt (1) |
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2,124,740 |
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0 |
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0.132 |
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August 11, 2011 |
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145,953 |
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187,658 |
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1.20 |
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August 8, 2012 |
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586,274 |
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382,615 |
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1.09 |
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August 8, 2017 |
6
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| (1) |
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On August 8, 2007, Mr. Brandt was granted options to purchase 1,302,500 shares of Common Stock.
The options are exercisable at $1.20 per share as to 333,611 shares and $1.09 per share as to
968,889 shares. The options to purchase 333,611 shares vest as follows: options to purchase
83,403 shares vested on August 8, 2007, the date of grant; options to purchase 243,250 shares vest
in equal monthly amounts of 6,950 shares over 35 months commencing on January 31, 2008; and the
remaining options to purchase 6,958 shares vest on December 31, 2010. The options to purchase
968,889 shares vest as follows: options to purchase 269,357 shares vested on August 8, 2007, the
date of grant; options to purchase 135,675 shares vested in equal monthly amounts of 27,135 shares
over 5 months beginning on August 31, 2007; options to purchase 543,726 shares vest in equal
monthly amounts of 20,138 shares over 27 months beginning on January 31, 2008; and the remaining
options to purchase 20,131 shares vest on April 30, 2010. |
7
PROPOSAL 2
TO AUTHORIZE THAT THE BOARD SHALL CONSIST OF FIVE (5) DIRECTORS
Leonard J. Brandt believes that the Stockholders should approve that the authorized number of
directors shall be five (5), subject to further change from time to time by subsequent resolutions
of the stockholders or the Board of Directors.
The Bylaws of the Company provide that the number of directors may be set from time to time by
resolution of the stockholders or the Board of Directors, with a minimum of three (3) directors and
no maximum number, and therefore the incumbent directors might increase the size of the Board in
order to retain seats on the Board until the next annual meeting.
When you sign, date and return the Proxy form, you will be authorizing that the Board shall
consist of five (5) directors, subject to further change from time to time by subsequent
resolutions of the stockholders or the Board to change the authorized number.
ADDITIONAL INFORMATION
During the past 10 years, (i) no participant in this solicitation has been convicted in a
criminal proceeding (excluding traffic violations or similar misdemeanors); (ii) no participant in
this solicitation directly or indirectly beneficially owns any of the Companys securities; (iii)
no participant in this solicitation owns any of the Companys securities which are owned of record
but not beneficially; (iv) no participant in this solicitation has purchased or sold any of the
Companys securities during the past two years; (v) no part of the purchase price or market value
of the Companys securities owned by any participant in this solicitation is represented by funds
borrowed or otherwise obtained for the purpose of acquiring or holding such securities; (vi) no
participant in this solicitation is, or within the past year was, a party to any contract,
arrangements or understandings with any person with respect to any of the Companys securities,
including, but not limited to, joint ventures, loan or option arrangements, puts or calls,
guarantees against loss or guarantees of profit, division of losses or profits, or the giving or
withholding of proxies; (vii) no associate of any participant in this solicitation owns
beneficially, directly or indirectly, any of the Companys securities; (viii) no participant in
this solicitation owns beneficially, directly or indirectly, any securities of any parent or
subsidiary of the Company; (ix) no participant in this solicitation or any of his/its associates
was a party to any transaction, or series of similar transactions, since the beginning of the
Companys last fiscal year, or is a party to any currently proposed transaction, or series of
similar transactions, to which the Company or any of its subsidiaries was or is to be a party, in
which the amount involved exceeds $120,000; (x) no participant in this solicitation has, nor do any
of their associates have, any arrangement or understanding with any person with respect to any
future employment by the Company or its affiliates; (xi) no participant in this solicitation has,
nor do any of their associates have, any arrangement or understanding with any person with respect
to any future transactions to which the Company or any of its affiliates will or may be a party;
(xii) no person, including the participants in this solicitation, who is a party to an arrangement
or understanding pursuant to which the Nominees are proposed to be elected has a substantial
interest, direct or indirect, by security holdings or otherwise in any matter to be acted on at the
Annual Meeting; (xiii) no participant in this solicitation is aware of any arrangement (including
any pledge, voting trust, or contract for sale) which may at a subsequent date result in a change
in control of the Company; (xvi) no participant in this solicitation is aware of any arrangement,
or has reason to believe that any arrangement exists, under which 5% or more of any class of the
Companys voting securities is held or is to be held subject to any voting agreement, voting trust
or other similar agreement; (xv) no participant in this solicitation is aware of any person or
group that holds beneficial ownership of more than 5% of the outstanding shares of the Company or
has the right to acquire beneficial ownership of more than 5% of such outstanding voting
securities, except for persons or groups who may be identified through a review of publicly
available information regarding the beneficial ownership of the Company.
The principal executive offices of the Company are located at 2755 Bristol Street, Suite 285,
Costa Mesa, California 92626.
8
The information concerning the Company set forth herein has been taken from, or is based upon,
publicly available information and information otherwise made available by the Company.
SECURITIES OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT
The following table sets forth the beneficial ownership of the Companys common stock as of
June 18, 2009, by (i) each person known by the Company to be the beneficial owner of more than five
percent (5%) of the Companys common stock, (ii) by each director, (iii) each of the Companys
principal executive officers, and (iv) all directors and executive officers as a group. The
following information as to the security ownership of the Company, other than information as to the
number of shares owned by Mr. Brandt, is based solely on the Companys filings with the Securities
and Exchange Commission and information available to Leonard J. Brandt.
The calculations of percentage of beneficial ownership are based on 25,970,447 shares of
Common Stock believed outstanding on June 18, 2009. Beneficial ownership is determined in
accordance with the rules of the SEC and generally includes voting or investment power with respect
to securities. Unless otherwise indicated in the footnotes below the table, to the Companys
knowledge, the persons and entities named in the table have sole voting and sole investment power
with respect to all shares beneficially owned, subject to community property laws where applicable.
Shares of Common Stock subject to options that are currently exercisable or exercisable within 60
days are deemed to be outstanding and to be beneficially owned by the person holding the options
for the purpose of computing the percentage ownership of that person but are not treated as
outstanding for the purpose of computing the percentage ownership of any other person.
Unless otherwise indicated, the address of each of the named executive officers, directors,
director nominees and 5% or more stockholders named below is c/o CNS Response, Inc., 2755 Bristol
St., Suite 285, Costa Mesa, CA 92626.
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Number of Shares |
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|
Beneficially Owned |
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|
Percentage of Shares |
|
| Name of Beneficial Owner |
|
Number |
|
|
Outstanding |
|
|
|
|
|
|
|
|
|
|
Named Executive Officers and Directors: |
|
|
|
|
|
|
|
|
Leonard J. Brandt (1)
Director |
|
|
7,934,631 |
|
|
|
28.0 |
% |
David B. Jones(2)
Director |
|
|
4,338,521 |
|
|
|
16.4 |
% |
Dr. Jerome Vaccaro
Director (3) |
|
|
20,000 |
|
|
|
* |
|
Dr. Henry Harbin
Director (4) |
|
|
100,834 |
|
|
|
* |
|
Daniel Hoffman
Chief Medical Officer (5) |
|
|
636,594 |
|
|
|
2.5 |
% |
George Carpenter
President (6) |
|
|
363,317 |
|
|
|
1.4 |
% |
Horace Hertz (7) |
|
|
298,492 |
|
|
|
1.2 |
% |
Brad Luce (8) |
|
|
17,187 |
|
|
|
* |
|
Executive Officers and Directors as a
group (8 persons) (9) |
|
|
15,205,977 |
|
|
|
47.3 |
% |
|
|
|
|
|
|
|
|
|
5% Stockholders: |
|
|
|
|
|
|
|
|
John Pappajohn (11) |
|
|
3,333,333 |
(10) |
|
|
10.2% |
(10) |
Sail Venture Partners LP (2) |
|
|
4,338,521 |
(2) |
|
|
16.4% |
(2) |
W. Hamlin Emory (11) |
|
|
1,317,099 |
|
|
|
5.1 |
% |
Heartland Advisors, Inc. (12) |
|
|
2,340,000 |
|
|
|
9.1 |
% |
EAC Investment Limited Partnership (13) |
|
|
1,766,279 |
|
|
|
6.8 |
% |
LMA SPC for and on behalf of Map 2
Segregated Portfolio;
Partner Healthcare Offshore Fund, Ltd.;
Partner Healthcare Fund, L.P. (14) |
|
|
1,625,000 |
|
|
|
6.3 |
% |
Brian MacDonald (15) |
|
|
2,208,908 |
|
|
|
8.4 |
% |
9
| |
|
|
| * |
|
Less than 1% |
| |
| (1) |
|
Includes 540,000 shares owned by Mr. Brandts children. |
| |
| (2) |
|
Consists of (a) 3,109,406 shares of Common Stock and (b)
1,329,115 shares of Common Stock issuable upon the exercise of
vested and exercisable warrants held by Sail Venture Partners,
LP. Sail Venture Partners, LLC is the general partner of Sail
Venture Partners, L.P.. The unanimous vote of the managing
members of Sail Venture Partners, LLC (who are Walter Schindler,
Alan Sellers, Thomas Cain, and David B. Jones), is required to
voting and make investment decisions over the shares held by
this selling stockholder. The address of Sail Venture Partners,
L.P. is 600 Anton Blvd., Suite 1750, Costa Mesa, CA 92626.
Excludes shares issuable under promissory notes in the amount of
$250,000 that may be convertible at a price higher or lower than
30 cents per share. |
| |
| (3) |
|
Consists of options to acquire 20,000 shares of common stock
issuable upon the exercise of vested and exercisable options. |
| |
| (4) |
|
Consists of (a) 8,333 shares of common stock, (b) 2,501 shares
of common stock issuable upon the exercise of warrants to
purchase common stock and (c) options to acquire 90,000 shares
of common stock issuable upon the exercise of vested and
exercisable options. |
| |
| (5) |
|
Consists of (a) 98,044 shares of common stock (b) options to
acquire 526,049 shares of common stock issuable upon the
exercise of vested and exercisable options, and (c) warrants to
acquire 12,501 shares of common stock. |
| |
| (6) |
|
Consists of options to acquire 363,317 shares of common stock
issuable upon the exercise of vested and exercisable options. |
| |
| (7) |
|
Consists of options to acquire 298,492 shares of common stock
issuable upon the exercise of vested and exercisable options. |
| |
| (8) |
|
Consists of options to acquire 17,187 shares of common stock
issuable upon the exercise of vested and exercisable options. |
| |
| (9) |
|
Consists of 8,354,774 shares of common stock and 6,851,203
shares of common stock issuable upon the exercise of vested and
exercisable options and warrants. |
10
| |
|
|
| (10) |
|
Consists of the 3,333,333 shares issuable under a seven-year
warrant to purchase shares of common stock for 30 cents each,
but excludes (under SEC rules) shares issuable upon conversion
of a promissory note in the amount of $1 million at a price
that is indeterminate. |
| |
| (11) |
|
Consists of 1,015,334 shares of common stock, 4,233 shares of
common stock issuable upon the exercise of warrants to purchase
common stock and 297,532 shares of common stock issuable upon
the exercise of vested and exercisable options to purchase
common stock. The address of Mr. Emory is 9663 Santa Monica
Blvd., Suite 221, Beverly Hills, CA 90210. |
| |
| (12) |
|
Consists of 1,800,000 shares of common stock and 540,000 shares
reserved for issuance upon exercise of warrants to purchase
common stock. Heartland Group Value Fund is affiliated with
Hartland Investor Services, LLC, a registered broker/dealer and
member of NASD. Heartland Group Value Fund purchased or
otherwise acquired its shares in the ordinary course of
business and, at the time of such purchase/acquisition, had no
agreements or understandings, directly or indirectly, with any
person, to distribute the securities to be resold. Mr. Paul T.
Beste, Vice President & Secretary of Heartland Group Inc.,
exercises voting and investment authority over the shares held
by this selling stockholder. The address of the selling
stockholder is c/o Brown Brothers Harriman, 140 Broadway St.,
New York, NY 10005. |
| |
| (13) |
|
Consists of 1,249,846 shares of common stock and 516,433 shares
of common stock issuable upon the exercise of warrants to
purchase common stock. Anthony Morgentheau exercises voting
and investment authority over the shares held by this selling
stockholder. The address of the selling stockholder is 380
Leucadendra Drive, Cora Gables, FL 33156. |
| |
| (14) |
|
Consists of 224,110 shares of common stock and 67,233 shares
reserved for issuance upon exercise of warrants to purchase
common stock held by LMA SPC for and on behalf of Map 2
Segregated Portfolio; 651,090 shares of common stock and
195,327 shares reserved for issuance upon exercise of certain
warrants to purchase common stock held by Partner Healthcare
Fund, LP, and 374,800 shares of common stock and 112,440 shares
reserved for issuance upon exercise of warrants to purchase
common stock held by Partner Healthcare Offshore Fund, Ltd.
Eric Moore, as the Chief Financial Officer of Partner
Healthcare Offshore Fund, Ltd., exercises voting and investment
authority over the shares held by Partner Healthcare Offshore
Fund, Ltd. Eric Moore, as the Chief Financial Officer of
Partner Healthcare Fund, L.P., exercises voting and investment
authority over the shares held by Partner Healthcare Fund,
L.P.. Robert P. Swan, as Director, exercises voting and
investment authority over the shares held by LMA SPC for and on
behalf of Map 2 Segregated Portfolio. The address of each of
the stockholders is One Market Plaza, Steuart Tower,
22nd Floor, San Francisco, CA 94105. |
| |
| (15) |
|
Consists of 1,242,375 shares of common stock and 966,533 shares
of common stock issuable upon the exercise of vested and
exercisable options to purchase common stock. The address of
Brian MacDonald is 4007 Beard Ave. South, Minneapolis, MN
55410. |
CHANGE IN CONTROL PROVISIONS
If the Nominees are elected to the Board of Directors of the Company, the Nominees intend to
review the terms of any change of control provisions that the Company is party to and evaluate
whether the change of control provisions contained therein have been triggered and, consistent with
their fiduciary duties, any other relevant circumstances.
DISSENTERS RIGHTS OF APPRAISAL
Stockholders have no dissenters rights of appraisal of similar rights with respect to the
Proposals.
11
STOCKHOLDER PROPOSALS FOR NEXT ANNUAL MEETING
The deadline for submitting stockholder proposals for inclusion in the Companys proxy
statement and form of proxy for the Companys next annual meeting is no later than a reasonable
time before the Company begins to print and send its proxy materials.
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Dated: July
_____
, 2009
|
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Sincerely, |
|
|
/s/ Leonard J. Brandt |
|
|
Leonard J. Brandt |
12
Definitive copies of this Proxy, when filed with the Securities and Exchange Commission, are
intended to be first sent, given or released to holders of Common Stock on July 6, 2009, or prior
to that date as the Securities and Exchange Commission may authorize upon a showing of good cause.
PROXY
THIS PROXY IS SOLICITED BY LEONARD J. BRANDT.
THIS PROXY WILL BE VOTED IN ACCORDANCE WITH YOUR INSTRUCTIONS AS INDICATED HEREON. IF NO
INDICATION IS MADE, THE SIGNED AND DATED PROXY WILL BE VOTED FOR ALL PROPOSALS.
The undersigned stockholder of CNS RESPONSE, INC., a Delaware corporation (the Company), hereby
appoints Leonard J. Brandt as proxy and attorney-in-fact with full power of substitution, on behalf
and in the name of the undersigned, to represent the undersigned at the Special Meeting of
Stockholders of the Company to be held on July 16, 2009, and at any adjournment(s) or
postponement(s) thereof, and to vote all shares of Common Stock that the undersigned would be
entitled to vote if then and there personally present, to cumulate such votes if cumulative voting
is requested, on the matters set forth below, to vote for any substitute nominee designated by
Leonard J. Brandt in any of the persons named below is unable to serve, to vote in the sole
discretion of Leonard J. Brandt on any other matter or matters that may properly come before the
meeting, to receive this proxy by electronic transmission and to copy and deliver this proxy in any
manner:
PROPOSAL 1: TO ELECT THE FOLLOWING PERSONS TO THE BOARD OF DIRECTORS OF CNS RESPONSE, INC. TO SERVE
UNTIL THE NEXT ANNUAL MEETING OF STOCKHOLDERS AND UNTIL THEIR SUCCESSORS ARE DULY ELECTED AND
QUALIFIED.
/ / APPROVE ALL / / WITHHOLD APPROVAL AS TO ALL / / ABSTAIN
TO WITHHOLD APPROVAL AS TO ANY INDIVIDUAL(S), STRIKE OUT THE NAME(S) BELOW.
Leonard J. Brandt William Murray Carl Cadwell Mordechay Yekutiel Andy Goren
PROPOSAL 2. TO SET THE NUMBER OF AUTHORIZED DIRECTORS AT FIVE (5), SUBJECT TO FURTHER CHANGE BY A
RESOLUTION ADOPTED BY THE STOCKHOLDERS OR THE BOARD OF DIRECTORS.
/ / APPROVE / / DISAPPROVE / / ABSTAIN
THE UNDERSIGNED AUTHORIZES LEONARD J. BRANDT OR HIS DESIGNATES TO DELIVER THIS PROXY AND COPIES
THEREOF AT THE MEETING OR TO CNS RESPONSE, INC. OR ITS AGENTS IN ANY MANNER.
SIGNATURE(S) [EACH PROXY MUST BE SIGNED AND DATED.]
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Dated: , 2009 |
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(Signature of Stockholder)
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Print Name |
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(Signature if held jointly)
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Print Name |
PLEASE FAX THIS PROXY TO 949-203-6161
OR SEND IT TO LEONARD J. BRANDT IN THE ENCLOSED ENVELOPE.