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. 2)
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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Fee paid previously with preliminary materials. |
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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.
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Sincerely,
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/s/ Leonard J. Brandt
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Leonard J. Brandt |
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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 31878 DEL OBISPO ST., SUITE 118-131, SAN JUAN CAPISTRANO, CA
92675 OR BY FAXING A WRITTEN REQUEST TO (949) 743-2785.
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 28,349,171 shares of Common Stock
outstanding as of June 26, 2009 according to the stockholder
list as of June 19, 2009, as received from American Stock and
Transfer Company and our calculations of various stockholder
exercises of warrants and options not reflected in that list. A majority of the
number of shares outstanding would be 14,202,934 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 (949) 743-2785 or send addressed to him at 31878 Del
Obispo St., Suite 118-131, San Juan Capistrano, CA 92675.
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 AT 31878 DEL OBISPO ST., SUITE 118-131,
SAN JUAN CAPISTRANO, CA 92675 OR BY FAX TO (949) 743-2785.
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
31878 Del Obispo St., Suite 118-131, San Juan Capistrano, CA 92675or by fax to (949) 743-2785 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 $150,000. Leonard J. Brandt has incurred
approximately $50,000 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
Leonard J. Brandt believes that the Stockholders should elect the Nominees as directors of the
Company to serve until the next annual meeting and until their successors are elected and
qualified.;
There are only five (5) nominees named in this proxy statement, and, therefore, the holders of
proxies shall only be entitled to vote for five (5) nominees. The Company currently has authorized
at least six (6) directors and may increase that number before the meeting takes place. If
Proposal 2 is adopted, then there will be five (5) authorized directors, all of whom will be
elected at the meeting. If Proposal 2 is not approved, then the number of authorized directors
will be the number that the Board of Directors determines prior to the meeting, and in that case
the Board could seat additional directors whose terms would continue after the meeting. For that
reason, Leonard Brandt recommends approval of Proposal 2.
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, currently serves as 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 48, has over 20 years of experience in the Medical Device and Life Science
areas. He is currently the President and Chief Executive Officer of ReShape Medical, Inc.
(ReShape), a development stage company focused on non-surgical therapies for the treatment of
obesity. Prior to ReShape, Mr. Murray has held various senior level executive positions. From
June 2006 through January 2008, he served as Chief Executive Officer of Murray Consulting, an
executive management consulting company. From January 2005 through May 2006, Mr. Murray served as
President of the Molecular Biology Division of Applied Biosystems, a company engaged in supplying
life science tools for genetic analysis. From June 2003 through June 2004, Mr. Murray served as
Group President of Respiratory Technologies at Viasys Healthcare, a company engaged in respiratory
therapy. From October 1985 through June 2003, Mr. Murray worked in various capacities at
Medtronic, Inc, a medical
technology services company. Prior to his departure he served as President of the Pacemaker
business. In addition to leading the Pacemaker 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. Mr.
Murray currently serves on the Board of Directors of ReShape Medical, Inc. and has previously
served as a director for Zinectics Medical, Inc. and Innovatus Ventures.
3
Carlton (Carl) Cadwell, age 65, cofounded Cadwell Laboratories, Inc. (Cadwell Laboraories)
in 1979 with his brother John. He has served as the President of Cadwell Laboratories from 1979 to
the present. Cadwell Laboratories is a leading manufacturer of neurodiagnostics equipment.
Cadwell Laboratories sells its products in 60 different countries. The major areas include EEG,
electromyography, sleep diagnostics and intraoperative monitoring. Carl also serves on the Board
of Directors of Advanced Medical Isotopes (ADMD.PK).
Mordechay Yekutiel, age 62, has had his primary profession of the last 33 years in commercial
real estate operating in CA, TX and NV. From March of 1988 to the present, Mr. Yekutiel has served
as President of Moty Yekutiel, Inc., a company acting as a manager of real estate enterprises.
Moty Yekutiel, Inc. serves as the General Partner for Masco Associates, Easco Corporation and Lake
Center LP, all real estate development companies. Mr. Yekutiels 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 38, From July 2006 to the present, Mr. Goren has served as President of
PharmaGenoma, Inc. (PharmaGenoma), a molecular dermatology research and development company.
PharmaGenoma is dedicated to the research and development of new prescription based therapies
tailored to an individuals genetic make up. During this time, from January 2008 to the present,
Mr. Goren has also served as President and Chief Executive Officer of HairDx LLC, a wholly-owned
subsidiary of PharmaGenoma and an FDA registered pharmacogenomics research and development company.
HairDX LLC markets the first genetic test for male and female hair loss. From June 2004 to July
2006, Mr. Goren served as Chief Executive Officer of BioQ, Inc., a medical device company
pioneering the treatment of gait and balance disorders due to peripheral neuropathy. Previously
Mr. Goren served as Chief Executive Officer of MobileWise, Inc., a revolutionary wire-free electric
power delivery system. 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.
4
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(2) |
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9,838,777 |
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32.5 |
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William Murray(4) |
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Carl Cadwell(5) |
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642,336 |
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2.3 |
% |
Mordechay Yekutiel(6) |
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198,394 |
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Andy Goren(7) |
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Total |
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8,733,021 |
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35.5 |
% |
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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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Mr. Brandts address is 31878 Del Obispo St., Suite 118-131, San Juan Capistrano, CA 92675. |
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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 as well as 601,646 shares
reserved for issuance upon exercise of warrants to purchase Common
Stock and 1,302,500 shares reserved for issuance upon exercise
of options to purchase Common Stock. |
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William Murrays address is 100 Calle Iglesia, San Clemente, CA 92672. |
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Carl Cadwells address is 909 North Kellogg St., Kennewick, WA 99336. |
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Mordechay Yekutiels address is 5106 Coldwater Canyon #22, Sherman Oaks, CA91423. |
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Andy Gorens address is 17682 Mitchell North, Suite 203, Irvine, CA 92614. |
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Consists of 600,006 shares on Common Stock held by Mr. Cadwell and 42,330 shares reserved for issuance upon
exercise of warrants to purchase Common Stock. |
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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Leonard J. Brandt |
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June 9, 2009 |
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607,900 |
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Leonard J. Brandt |
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June 19, 2009 |
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2,124,740 |
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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
Litigation
On Monday, June 29, 2009, the Delaware Court of Chancery denied a motion brought by the
Company seeking a Temporary Restraining Order against Leonard Brandt, seeking to prohibit him from
calling a special stockholder meeting. The Companys complaint was filed on Friday, June 26, 2009
in the Delaware Court of Chancery and captioned CNS Response, Inc. v. Leonard Brandt, Meyerlen,
LLC, EAC Investment LP et al. (CA
_____
). The Company sought a court order prohibiting a meeting
of stockholders from taking place. The Company argued that it would suffer irreparable harm if the
meeting were allowed to take place. The Court determined that holding a stockholders meeting
would not cause the Company irreparable harm because the Company will have adequate opportunity
after the meeting is held to raise challenges as to validity of the meeting.
5
CERTAIN RELATIONSHIPS
On March 30, 2009, the Company entered into two Senior Secured Convertible Promissory Notes,
each in the principal amount of $250,000 (each a Note and, collectively, the Notes), with
Brandt Ventures, GP (Brandt Ventures) and SAIL Venture Partners, LP (SAIL). Leonard Brandt is
the general partner of Brandt Ventures. The Notes accrue interest at the rate of 8% per annum.
The Notes are secured by a lien on substantially all of the assets (including all intellectual
property) of the Company. The respective rights of each of Brandt Ventures and SAIL in respect of
the lien are to remain on a parity with one each other without preference, priority or distinction
during all times when both Notes are outstanding.
The Notes provide that any repayment made under either Note shall be made to each of Brandt
Ventures and SAIL in equal amounts. However, SAIL subsequently entered into a loan agreement with
the Company in which the Company agreed that, if SAIL demands the Company to do so, the Company
will repay Brandt Ventures without repaying SAIL.
On June 30, 2009, each Note became due and payable if Brandt Ventures or SAIL, respectively,
declares its respective Note due and payable. Although nonpayment on June 30, 2009 constituted an
Event of Default as defined in the Notes, an earlier Event of Default occurred under the Notes when
the Company terminated Leonard Brandt in April, 2009. At any time thereafter, the holders of the
Notes could have together declared both Notes due and payable.
In the event of a liquidation, dissolution or winding up of the Company, unless Brandt and/or
SAIL informs the Company otherwise, the Company shall pay such investor an amount equal to the
product of 250% multiplied by the principal and all accrued but unpaid interest outstanding on the
Note. A similar provision is found in connection with a subsequent $200,000 in original principal
amount of additional secured indebtedness to SAIL, and a later subsequent $1,000,000 in original
principal amount plus a premium of $90,000 of secured indebtedness incurred to John Pappajohn.
Accordingly, in connection with the Notes, the subsequent indebtedness, and the liens accompanying
them, a liquidation, dissolution or winding up of the Company could result in up to $1,250,000
becoming payable under the Notes, including $675,000 payable to Brand Ventures under its Note, plus
up to $2,920,000 becoming payable under the subsequent indebtedness to SAIL and John Pappajohn, in
each case not counting 250% of the accrued and unpaid interest and other charges permitted under
the Notes or other related agreements.
The Notes provide that the principal and all accrued but unpaid interest outstanding under the
Notes shall be automatically converted into the securities issued in an equity financing
transaction of at least $1,500,000 (excluding any and all other debt that is converted), on the
same terms as those offered to the lead investor in the equity financing except at a price for the
securities of 90% of the per share price paid by the investors in such financing.
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.
On
March 30, 2009, Leonard J. Brandt made a loan of $250,000 to the Company with his personal funds, and such loan is
evidenced by a secured 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 secured promissory note is not presently convertible, and 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. For further discussion of the
secured promissory notes issued by the Company to Mr. Brandt please
see the preceding section CERTAIN RELATIONSHIPS. At some future time, Brandt may acquire securities of the
Company under the terms of this secured promissory note. On April 10, 2009, the Company released Mr. Brandt from
employment which was a default under the terms of the secured
promissory note, making the secured promissory note immediately due
and payable. The secured promissory note has not been repaid and is
still in default. For further discussion of the employment agreement
between Mr. Brandt and the Company, please see the section
COMPENSATION BY THE COMPANY OF PARTICIPANTS subheading
Employment Agreement.
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.
In
the event the Nominees are elected, Leonard Brandt intends to request
that the Board of Directors consider payment of the amounts Mr.
Brandt believes are due under the terms of the secured promissory
notes issued to Mr. Brandt by the Company on March 30, 2009.
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.
Independence of Nominees
Except for Leonard J. Brandt, who served as the Companys Chief Executive Officer until April,
2009, all of the other nominees named in this proxy statement for election at the meeting are
independent, as independence is defined under the listing standards of the NASDAQ Stock Market, for
purposes of board membership and committee memberships on all committees.
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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| Name and |
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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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| Principal Positions |
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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 |
(5) |
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0 |
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19,000 |
(4) |
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194,000 |
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(Chief Executive Officer, |
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2007 |
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175,000 |
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0 |
(6) |
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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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Principal Executive Officer, Director)(1) |
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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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| (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). |
6
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| (2) |
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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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| (3) |
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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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| (4) |
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Relates to healthcare insurance premiums paid on behalf of executive officers by the Company. |
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| (5) |
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For the 2008 fiscal first quarter ending December 31,
2007, Mr. Brandt was awarded but not paid a bonus of $9,531. |
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| (6) |
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For Fiscal 2007, Mr. Brandt was awarded but not paid a
bonus. |
Outstanding Equity Awards at Fiscal Year-End 2008
The following table presents information regarding outstanding options held by the
participants in the solicitation as of the end of the Companys fiscal year ended September 30,
2008. None of the participants exercised options during the fiscal year ended September 30, 2008.
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Number of Securities Underlying |
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Unexercised Options (#) |
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Option Exercise |
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Option Expiration |
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| Name |
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Exercisable |
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Unexercisable |
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Price ($) |
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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 |
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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. |
Narrative Disclosure to Summary Compensation Table and Grants of Plan-Based Awards Table
As the Company desired to retain our cash to fund our growth, the Company did not pay any
bonuses to Leonard J. Brandt or any other executive officers during fiscal years ended September
30, 2008 and 2007. The bonus of $10,000 paid to Leonard J. Brandt in the fiscal year ended 2006
was determined by the Companys Board of Directors, based on the performance of Mr. Brandt and of
the Company.
The Company does not have a formal plan for determining the compensation of executive
officers. Instead, each named executive officer negotiates the terms of their employment.
Employment Agreement
Prior to March 2007, CNS California entered into an Employment Agreement (the Employment
Agreement) with Leonard J. Brandt. On March 7, 2007, the merger transaction between the Companys
subsidiary and CNS California was consummated. It is Mr. Brandts belief that the Employment
Agreement with CNS California continued. During the period of his employment, Mr. Brandt received
a base salary of $175,000 per year plus group healthcare insurance.
Under the Employment Agreement, Mr. Brandts employment was on an at-will basis. Upon
involuntary termination of Mr. Brandts employment, Mr. Brandt was to become eligible to receive as
severance his salary and benefits for a period equal to six months payable in one lump sum of
$87,500. Mr. Brandt did not receive that amount and reserves his rights to assert a claim for such
amount.
2006 Stock Incentive Plan
On August 3, 2006, CNS California adopted the CNS California 2006 Stock Incentive Plan (the
2006 Plan). On March 7, 2007, in connection with the closing of the merger transaction with CNS
California, the Company assumed the 2006 Plan and all of the options granted under the plan at the
same price and terms. The following is a summary of the 2006 Plan, which the Company uses to
provide equity compensation to employees, directors and consultants to the Company.
The 2006 Plan provides for the issuance of awards in the form of restricted shares, stock
options (which may constitute incentive stock options (ISO) or nonstatutory stock options (NSO)),
stock appreciation rights and stock unit grants to eligible employees, directors and consultants
and is administered by the board of directors. A total of 10 million shares of Common Stock are
reserved for issuance under the 2006 Plan. As of September 30, 2008, there were 8,964,567 options
and 183,937 restricted shares outstanding under the 2006 Plan and 498,739 shares available for
issuance of awards. The 2006 Plan provides that in any calendar year, no eligible employee or
director shall be granted an award to purchase more than 3 million shares of stock. The option
price for each share of stock subject to an option shall be (i) no less than the fair market value
of a share of stock on the date the option is granted, if the option is an ISO, or (ii) no less
than 85% of the fair market value of the stock on the date the option is granted, if the option is
a NSO; provided, however, if the option is an ISO granted to an eligible employee who is a 10%
shareholder, the option price for each share of stock subject to such ISO shall be no less than
110% of the fair market value of a share of stock on the date such ISO is granted. Stock options
have a maximum term of ten years from the date of grant, except for ISOs granted to an eligible
employee who is a 10% shareholder, in which case the maximum term is five years from the date of
grant. ISOs may be granted only to eligible employees.
Compensation Discussion and Analysis
The Company does not have a designated compensation committee, its full Board of Directors
oversees matters regarding executive compensation. The Board is responsible for all compensation
functions. The Board also has the authority to select and/or retain outside counsel,
compensation and benefits consultants, or any other consultants to provide independent advice and
assistance in connection with the execution of its responsibilities.
Compensation Philosophy
The Company does not have a formal comprehensive executive compensation policy. It intends to
establish such policies to further its corporate objectives.
Compensation Elements
The Company compensates its executives through a variety of components, which may include a
base salary, annual performance based incentive bonuses, equity incentives, and benefits and
perquisites, in order to provide its executives with a competitive overall compensation package.
The mix and value of these components are impacted by a variety of factors, such as responsibility
level, individual negotiations and performance and market practice. The purpose and key
characteristics for each component are described below.
Severance and Change of Control Arrangements
The Company does not have a formal plan for severance or separation pay for its employees, but
the Company typically includes a severance provision in the employment agreements of its executive
officers that have written employment agreements with us. Generally, such provisions are triggered
in the event of involuntary termination of the executive without cause or in the event of a change
in control.
Accounting and Tax Considerations
The Company considers the accounting implications of all aspects of its executive compensation
strategy and, so long as doing so does not conflict with its general performance objectives
described above, the Company strives to achieve the most favorable accounting (and tax) treatment
possible to the company and its executive officers.
Process for Setting Executive Compensation; Factors Considered
When making pay determinations for named executive officers, the Board considers a variety of
factors including, among others: (1) actual company performance as compared to pre-established
goals, (2) individual executive performance and expected contribution to its future success, (3)
changes in economic conditions and the external marketplace, (4) prior years bonuses and long-term
incentive awards, and (5) in the case of executive officers, other than Chief Executive Officer,
the recommendation of its Chief Executive Officer. No specific weighing is assigned to these
factors nor are particular targets set for any particular factor. Ultimately, the Board uses its
judgment and discretion when determining how much to pay its executive officers and sets the pay
for such executives by element (including cash versus non-cash compensation) and in the aggregate,
at levels that it believes are competitive and necessary to attract and retain talented executives
capable of achieving the Companys long-term objectives.
COMPANYS BOARD COMPOSITION AND COMMITTEES
Leonard J. Brandt serves as a director of the Company and until April, 2009 served as Chairman
of the Board.
Information provided by the Company indicates as follows:
The Companys board of directors currently consists of five members: Leonard Brandt, George
Carpenter, David Jones, Jerome Vaccaro and Henry Harbin. Except for Messrs. Carpenter and Harbin,
who were appointed by the Board of Directors to fill vacancies created by expansions in the size of
the Board of Directors, each director was elected either at a meeting of shareholders or by written
consent of the shareholders of CNS California and became a director of the Company in connection
with the merger of CNS California with a subsidiary of the Company.
Each of the Companys directors will serve until the next annual meeting or until his or her
successor is duly elected and qualified.
The Company is not a listed company under SEC rules and are therefore not required to have
separate committees comprised of independent directors. The Company has, however, determined that
David Jones, Jerome Vaccaro and Henry Harbin are independent as that term is defined in Section
4200 of the Marketplace Rules as required by the NASDAQ Stock Market. It has also determined that
David Jones qualifies as an audit committee financial expert within the meaning of the rules and
regulations of the SEC and that each of its other board members are able to read and understand
fundamental financial statements and have substantial business experience that results in that
members financial sophistication. Accordingly, the Companys board of directors believes that each
of its members has sufficient knowledge and experience necessary to fulfill the duties and
obligations that an audit committee would have. The Company does not have a separately designated
audit, compensation or nominating committee of its board of directors and the functions customarily
delegated to these committees are performed by its full board of directors.
Compensation Committee Interlocks and Insider Participation
The Company does not have a separately designated compensation committee of its board of
directors and the functions customarily delegated to this committee are performed by its full board
of directors. During its fiscal year ended September 30, 2008, Leonard Brandt, then the Companys
Chief Executive Officer in addition to being a director, participated in deliberations of the
board of directors concerning executive officer compensation. No relationship with another entity
or its officers or directors that would require disclosure under this caption had existed during
fiscal year 2008.
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
Please
see the following sections for information about the participants:
Information with Respect to Nominees, Security
Ownership of Participants, Transactions of the
Participants in Company Securities, Legal
Proceedings, Interests of Nominees,
Arrangements and Undertakings with Nominees,
Compensation by the Company of the Participants. Each of
these sections is included under the discussion of Proposal
No. 1 beginning on page 3. Except as set forth in the
aforementioned sections, 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 28,349,171 shares of
Common Stock believed outstanding on June 26, 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 |
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| Name of Beneficial Owner |
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Number |
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Shares Outstanding |
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Named Executive Officers and Directors: |
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Leonard J. Brandt (1)
Director |
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9,838,777 |
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32.5 |
% |
David B. Jones(2)
Director |
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4,338,521 |
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15.0 |
% |
Dr. Jerome Vaccaro
Director (3) |
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20,000 |
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* |
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Dr. Henry Harbin
Director (4) |
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100,834 |
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* |
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Daniel Hoffman
Chief Medical Officer (5) |
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636,594 |
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2.2 |
% |
George Carpenter
President (6) |
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363,317 |
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1.3 |
% |
Horace Hertz (7) |
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298,492 |
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1.0 |
% |
Brad Luce (8) |
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17,187 |
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* |
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Executive Officers and Directors as a
group (8 persons) (9) |
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13,809,576 |
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52 |
% |
9
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Number of Shares |
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Beneficially Owned |
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Percentage of |
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| Name of Beneficial Owner |
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Number |
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Shares Outstanding |
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5% Stockholders: |
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John Pappajohn (10) |
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3,333,333 |
(10) |
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10.5 |
%(10) |
Sail Venture Partners LP (2) |
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4,438,521 |
(2) |
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15.0 |
%(2) |
W. Hamlin Emory (11) |
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1,317,099 |
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4.6 |
% |
Heartland Advisors, Inc. (12) |
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2,340,000 |
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8.1 |
% |
EAC Investment Limited Partnership (13) |
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1,766,279 |
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6.1 |
% |
LMA SPC for and on behalf of Map 2
Segregated Portfolio;
Partner Healthcare Offshore Fund, Ltd.; |
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Partner Healthcare Fund, L.P. (14) |
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1,625,000 |
|
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5.7 |
% |
Brian MacDonald (15) |
|
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2,208,908 |
|
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7.5 |
% |
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| * |
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Less than 1% |
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| (1) |
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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 as well as 601,646 shares reserved for
issuance upon exercise of warrants to purchase Common Stock and
1,302,500 shares reserved for issuance upon exercise of options
to purchase Common Stock. |
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| (2) |
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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. |
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| (3) |
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Consists of options to acquire 20,000 shares of common stock
issuable upon the exercise of vested and exercisable options. |
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| (4) |
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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. |
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| (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. |
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| (6) |
|
Consists of options to acquire 363,317 shares of common stock
issuable upon the exercise of vested and exercisable options. |
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| (7) |
|
Consists of options to acquire 298,492 shares of common stock
issuable upon the exercise of vested and exercisable options. |
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| (8) |
|
Consists of options to acquire 17,187 shares of common stock
issuable upon the exercise of vested and exercisable options. |
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| (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
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| (10) |
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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. |
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| (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. |
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| (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. |
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| (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. |
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| (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. |
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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.
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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 |
Sincerely,
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/s/ Leonard J. Brandt
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Leonard J. Brandt |
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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.
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o APPROVE ALL
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o WITHHOLD APPROVAL AS TO ALL
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o 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.
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| o APPROVE
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o DISAPPROVE
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o 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.]
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
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PLEASE FAX THIS PROXY TO 949-743-2785
OR SEND IT TO LEONARD J. BRANDT IN THE ENCLOSED ENVELOPE.
CONSENT OF NOMINEE
The undersigned hereby consents to being named as a nominee for election as a director of CNS
Response, Inc., a Delaware corporation (the Company) in the proxy statement and other proxy
materials concerning the undersigneds nomination in connection with the solicitation from
stockholders of the Company of proxies to be voted at the 2009 special meeting of stockholders of
the Company, including any adjournments or postponements thereof, and, if elected, to serve as a
director of the Company.
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/s/ Leonard J. Brandt
Name: Leonard J. Brandt
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Date: June 26, 2009 |
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CONSENT OF NOMINEE
The undersigned hereby consents to being named as a nominee for election as a director of CNS
Response, Inc., a Delaware corporation (the Company) in the proxy statement and other proxy
materials concerning the undersigneds nomination in connection with the solicitation from
stockholders of the Company of proxies to be voted at the 2009 special meeting of stockholders of
the Company, including any adjournments or postponements thereof, and, if elected, to serve as a
director of the Company.
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/s/ Andy Goren
Name: Andy Goren
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CONSENT OF NOMINEE
The undersigned hereby consents to being named as a nominee for election as a director of CNS
Response, Inc., a Delaware corporation (the Company) in the proxy statement and other proxy
materials concerning the undersigneds nomination in connection with the solicitation from
stockholders of the Company of proxies to be voted at the 2009 special meeting of stockholders of
the Company, including any adjournments or postponements thereof, and, if elected, to serve as a
director of the Company.
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/s/ Carlton M. Cadwell
Name: Carlton M Cadwell
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June 11, 2009 |
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CONSENT OF NOMINEE
The undersigned hereby consents to being named as a nominee for election as a director of CNS
Response, Inc., a Delaware corporation (the Company) and, if elected, to serve as a director of
the Company.
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/s/ Mordechay Yekutiel
Name: Mordechay Yekutiel
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CONSENT OF NOMINEE
The undersigned hereby consents to being named as a nominee for election as a director of CNS
Response, Inc., a Delaware corporation (the Company) in the proxy statement and other proxy
materials concerning the undersigneds nomination in connection with the solicitation from
stockholders of the Company of proxies to be voted at the 2009 special meeting of stockholders of
the Company, including any adjournments or postponements thereof, and, if elected, to serve as a
director of the Company.
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/s/ William Murray
Name: William Murray
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Date: June 28, 2009 |
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