SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
Amendment
No. 1 to
SCHEDULE
13D
(Rule
13d-101)
INFORMATION
TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO
§ 240.13d-1(a) AND AMENDMENTS THERETO FILED PURSUANT TO
§ 240.13d-2(a)
CNS
RESPONSE, INC.
(Name of
Issuer)
Common
Stock
(Title of
Class of Securities)
12619C101
(CUSIP
Number)
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John
Pappajohn
c/o
Equity Dynamics Inc.
666
Walnut Street, Suite 2116
Des
Moines, IA 50309
(515)
244-2346
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(Name,
Address and Telephone Number of Person
Authorized
to Receive Notices and Communications)
July
25, 2010
(Date of
Event Which Requires Filing of This Statement)
If the
filing person has previously filed a statement on Schedule 13G to report the
acquisition that is the subject of this Schedule 13D, and is filing this
schedule because of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check
the following box .
Note: Schedules
filed in paper format shall include a signed original and five copies of the
schedule, including all exhibits.
See § 240.13d-7 for other parties to whom copies are to
be sent.
_______________
* The remainder of this
cover page shall be filled out for a reporting person’s initial filing on this
form which respect to the subject class of securities, and for any subsequent
amendment containing information which would alter disclosures provided in a
prior cover page.
The information required on the
remainder of this cover page shall not be deemed to be “filed” for the purpose
of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise
subject to the liabilities of that section of the Act but shall be subject to
all other provisions of the Act.
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NAMES OF REPORTING PERSONS:
JOHN
PAPPAJOHN
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I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS
(ENTITIES ONLY): |
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(SEE INSTRUCTIONS):
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(a) o |
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(b) x |
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SEC USE ONLY: |
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SOURCE OF FUNDS (SEE INSTRUCTIONS): |
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PF
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CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS
REQUIRED PURSUANT TO ITEMS 2(d) OR 2(e): |
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o |
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CITIZENSHIP OR PLACE OF ORGANIZATION: |
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USA
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7 |
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SOLE VOTING POWER: |
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| NUMBER OF |
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13,019,536
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| SHARES |
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SHARED VOTING POWER: |
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| OWNED BY |
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0
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| EACH |
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SOLE DISPOSITIVE POWER: |
| REPORTING |
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| PERSON |
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13,019,536
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| WITH |
10 |
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SHARED DISPOSITIVE POWER: |
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0
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH
REPORTING PERSON: |
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13,019,536
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CHECK IF THE AGGREGATE AMOUNT IN ROW
(11) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS): |
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o |
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW
(11): |
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21.5%
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TYPE OF REPORTING PERSON (SEE
INSTRUCTIONS): |
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IN |
ITEM
1. Security and Issuer.
This
statement relates to the common stock, $0.001 par value (the “Common Stock”), of CNS
Response, Inc., a Delaware corporation (the “Issuer”). The
Issuer’s principal executive offices are located at 85 Enterprise, Suite 410,
Aliso Viejo, CA 92656.
ITEM
2. Identity and Background.
(a) The
name of the reporting person is Mr. John Pappajohn (the “Reporting
Person”).
(b) The
business address of the Reporting Person is c/o Equity Dynamics Inc., 666 Walnut
Street, Suite 2116, Des Moines, IA 50309.
(c) The
Reporting Person is the President and sole owner of Pappajohn Capital Resources,
a venture capital firm, and President and sole owner of Equity Dynamics, Inc., a
financial consulting firm, both located in Des Moines, Iowa.
(d) During
the last five years, the Reporting Person has not been convicted in a criminal
proceeding.
(e) During
the last five years, the Reporting Person has not been a party to a civil
proceeding of a judicial or administrative body of competent jurisdiction and as
a result of such proceeding was or is subject to a judgment, decree or final
order enjoining future violations of, or prohibiting or mandating activities
subject to, federal or state securities laws or finding any violation with
respect to such laws.
(f) The
Reporting Person is a citizen of United States of America.
ITEM
3. Source and Amount of Funds or Other Consideration.
Reference
is made to the disclosure set forth under Item 4 of this Schedule 13D, which
disclosure is incorporated herein by reference. The
consideration used in making the purchases described in Item 4 of this Schedule
13D were personal funds of the Reporting Person.
ITEM
4. Purpose of Transaction.
On July
25, 2010, the Reporting Person loaned the Issuer $250,000 in exchange for a
secured promissory note. The Reporting Person also received a warrant
to purchase up to 250,000 shares of the Issuer’s common stock (the “July 2010
Warrant”) in connection with the loan. The note and the 2010 Warrant
were issued pursuant to a Bridge Note and Warrant Purchase Agreement (the “2010
Purchase Agreement”), dated June 3, 2010, between the Issuer and the Reporting
Person. The Reporting Person had purchased the first of the two
$250,000 notes (collectively, the “2010 Notes”) contemplated under the 2010
Purchase Agreement on June 3, 2010. The 2010 Notes both have a
maturity date of December 2, 2010 and accrue interest at a rate of 9% per annum,
which is payable together with the repayment of the principal amount at the
earliest of (i) the maturity date; (ii) prepayment of the note at the option of
the Issuer, (iii) closing of a financing in which the aggregate proceeds to the
Issuer are not less than $3,000,000 or (iv) the occurrence of an Event of
Default (as defined in the 2010 Notes). The 2010 Purchase Agreement
and the 2010 Notes grant the Reporting Person a senior security interest in and
to all of the Issuer’s existing and future right, title and interest in its
tangible and intangible property. The exercise price of the July 2010 Warrant is
$0.50 per share.
As of
July 25, 2010, the Reporting Person and the Issuer entered into an agreement
pursuant to which the Issuer granted the Reporting Person the right to convert
the 2010 Notes into shares of common stock at a conversion price of $0.50 per
share. The 2010 Notes are therefore immediately convertible into
1,000,000 shares of Common Stock.
On March
3, 2010, the Reporting Person, a member of the Issuer’s Board of Directors, was
granted an option to purchase 250,000 shares of Common Stock at an exercise
price of $0.55 per share, which vests in 36 equal monthly installments
commencing on March 3, 2010.
On
February 23, 2010 the Reporting Person exercised a warrant to purchase 2,333,333
shares of Common Stock (referred to as the “June 2009 Investment Warrant” below)
and was issued 1,720,910 shares of Common Stock in a net issue exercise of such
warrant.
On
August 26, 2009, the Issuer completed an equity financing transaction yielding
gross proceeds of approximately $2 million. Pursuant to the terms of
the June 2009 Investment Note (described below) held by the Reporting Person,
(i) such note was therefore automatically converted into 3,333,334 shares of
Common Stock and (ii) the Reporting Person received a five year non-callable
warrant to purchase 1,666,667 shares of Common Stock at an exercise price of
$0.30 per share (the “August 2009 Conversion Warrant”).
In
connection with the August 26, 2009 equity financing, the Reporting Person
invested $1,000,000 in the Issuer. In exchange for this investment,
the Reporting Person received an additional 3,333,333 shares of Common Stock and
a five year non-callable warrant to purchase 1,666,667 shares of Common Stock at
an exercise price of $0.30 per share (the “August 2009 Investment
Warrant”). This terms of this investment were identical to the terms
received by all other investors in the Issuer’s private placement that closed on
August 26, 2009, December 24, 2009, December 31, 2009 and January 4,
2010.
On June
12, 2009, the Issuer and the Reporting Person entered into a Bridge Note and
Warrant Purchase Agreement (the “2009 Purchase Agreement”), pursuant to which
the Reporting Person purchased a secured convertible promissory note in the
principal amount of $1,000,000 from the Issuer (the “June 2009 Investment
Note”). In order to induce the Reporting Person to purchase the June
Investment Note, the Issuer issued to the Reporting Person a warrant to purchase
up to 2,333,333 shares of Common Stock (the “June 2009 Investment Warrant ”) and
issued to relatives of the Reporting Person warrants to purchase up to a total
of 1,000,000 shares, all at a purchase price equal to $0.30 per
share. As described above, the June 2009 Investment Warrant was
exercised by the Reporting Person on a net issue exercise basis on February 23,
2010 for an aggregate of 1,720,910 shares of Common Stock.
The
June 2009 Investment Note had provided that the principal amount of $1,000,000
together with a single premium payment of $90,000, was due and payable, unless
sooner converted into shares of Common Stock (as described below), upon the
earlier to occur of: (i) a declaration by the Reporting Person on or after June
30, 2010 that such amounts were due and payable or (ii) an event of default as
defined in the June 2009 Investment Note. The June 2009 Investment
Note had been secured by a lien on substantially all of the Issuer’s assets
(including all intellectual property). In the event of a liquidation,
dissolution or winding up of the Issuer, unless the Reporting Person informed
the Issuer otherwise, the Issuer would have been required to pay the Reporting
Person an amount equal to the product of 250% multiplied by the then outstanding
principal amount of the June 2009 Investment Note and the premium
payment.
The
June 2009 Investment Note had also contained a provision that, in the event the
Issuer consummated an equity financing transaction of at least $1,500,000
(excluding any and all other debt that is converted) with the principal purpose
of raising capital, the then outstanding principal amount of the June 2009
Investment Note (but excluding the premium payment, which was to be repaid in
cash at the time of such equity financing) would be automatically converted into
the securities issued in the equity financing by dividing such amount by the per
share price paid by the investors in such financing. As described
above, the June 2009 Investment Note was automatically converted into 3,333,334
shares of Common Stock as a result of the August 26, 2009 equity
financing.
ITEM
5. Interest in Securities of the Issuer.
Reference
is made to the disclosure set forth under Item 4 of this Schedule 13D, which
disclosure is incorporated herein by reference.
(a) As
of the date of this filing, the Reporting Person beneficially owns 13,019,536
shares of Common Stock of the Issuer, which represents approximately 21.5% of a
total of 56,023,921 shares of Common Stock of the Issuer outstanding as of July
27, 2010 (calculated in accordance with Rule 13d-3 under the Securities Exchange
Act of 1934, as amended). Of the
13,019,536 shares beneficially owned by the Reporting Person, he owns 8,387,578
shares directly and the remainder indirectly, as follows: (i)
1,000,000 shares are issuable upon conversion of convertible notes, (ii)
3,583,334 shares are issuable upon exercise of warrants and (iii) 48,624 shares
are issuable upon exercise of vested options.
(b) The
Reporting Person may be deemed to hold sole power to vote and to dispose of the
13,019,536 shares of the Issuer’s Common Stock described in (a)
above.
(c) The
Reporting Person had purchased a 2010 Note in the aggregate principal amount of
$250,000 under the 2010 Purchase Agreement on June 3, 2010, as further described
in Item 4 above.
(d) No
person other than the Reporting Person is known to have the right to receive, or
the power to direct the receipt of, dividends from, or proceeds from the sale
of, the shares of Common Stock reported in this to Schedule 13D.
(e) Not
applicable.
ITEM
6. Contracts, Arrangements, Understandings or Relationships With Respect to
Securities of the Issuer.
Other
than the arrangements discussed in Item 4 of this Schedule 13D, the discussion
of which is incorporated by reference herein, and other than an agreement by the
Issuer to enter into a registration rights agreement with the Reporting Person
covering the securities issuable upon exercise of the 2010 Warrant, there are no
other contracts, arrangements, understandings or relationships between the
Reporting Person and any other person, with respect to the securities of the
Issuer.
ITEM
7. Material to be filed as Exhibits.
None.
CUSIP NO.
12619C101
SIGNATURES
After
reasonable inquiry and to the best of their knowledge and belief, the
undersigned certify that the information set forth in this statement is true,
complete and correct.
Dated: July
27, 2010
/s/ John
Pappajohn