UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
8-K
CURRENT
REPORT
Pursuant
to Section 13 or 15(d) of the Securities Exchange Act of 1934
Date of
Report (Date of Earliest Event Reported): August 20,
2010
CNS
RESPONSE, INC.
(Exact
name of Company as specified in its charter)
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Delaware
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0-26285
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87-0419387
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(State
or other
jurisdiction
of
incorporation)
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(Commission
File No.)
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(I.R.S.
Employer
Identification
No.)
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85
Enterprise, Suite 410
Aliso
Viejo, CA 92656
(Address
of principal executive offices)
(714)
545-3288
(Registrant’s
telephone number, including area code)
Not
Applicable
(Former
name or former address, if changed since last report)
Check the
appropriate box below if the Form 8-K filing is intended to simultaneously
satisfy the filing obligation of the registrant under any of the following
provisions:
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o
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Written
communications pursuant to Rule 425 under the Securities Act (17 CFR
230.425)
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o
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Soliciting
material pursuant to Rule 14a-12 under the Exchange Act (17 CFR
240.14a-12)
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o
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Pre-commencement
communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR
240.14d-2(b))
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o
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Pre-commencement
communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR
240.13e-4(c))
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Item
2.03
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Creation
of a Direct Financial Obligation or an Obligation under an Off-Balance
Sheet Arrangement of a Registrant.
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On August
20, 2010, CNS Response Inc. (the “Company”) issued two unsecured convertible
promissory notes (each, a “Note”) in the aggregate principal amount of $250,000
to Deerwood Partners LLC and Deerwood Holdings LLC (collectively, the
“Investors”), with each Investor purchasing a Note in the aggregate principal
amount of $125,000. The Notes mature on December 15,
2010. The Company received $250,000 in gross proceeds from the
issuance of the Notes. Each Investor also received a warrant to
purchase up to 75,000 shares of common stock of the Company at an exercise price
(subject to customary anti-dilution adjustments) of $0.56 per share (each, a
“Warrant”).
On August
20, 2010, SAIL Venture Partners L.P. (the “Guarantor”), of which the Company’s
director David Jones is a managing partner, issued an unconditional guaranty
(each, a “Guaranty”) to each Investor, guaranteeing the prompt and complete
payment when due of all principal, interest and other amounts under each
Note. The obligations under each Guaranty are independent of the
Company’s obligations under the Notes and separate actions may be brought
against the Guarantor. The Company has agreed to indemnify the
Guarantor and grant to the Guarantor a security interest in its assets in
connection with the Guaranties. In addition, the Company granted the
Guarantor Warrants to purchase up to an aggregate of 100,000 shares of common
stock.
Each Note
accrues interest at a rate of 9% per annum, which will be paid together with the
repayment of the principal amount, unless earlier converted, at the earliest of
(i) the maturity date; (ii) prepayment of the Note at the option of the Company
(iii) closing of a financing in which the aggregate proceeds to the Company are
not less than $3,000,000 or (iv) the occurrence of an Event of Default (as
defined in the Note). Each Note is convertible into shares of the
Company’s common stock at a conversion price of $0.50. The conversion
price is subject to customary anti-dilution adjustments, but will never be less
than $0.30.
The Company has agreed to enter
into a registration rights agreement covering the securities issuable upon
conversion of the Notes and exercise of the Warrants.
The
managing members of each of Deerwood Partners LLC and Deerwood Holdings LLC are
George J. Kallins, M.D. and his spouse Bettina Kallins. Dr.
Kallins was appointed to the Company’s Board on July 5, 2010.
The
foregoing description of the Notes and Warrants does not purport to be complete
and is qualified in its entirety by reference to the full text of the form of
Note and form of Warrant, which are filed as Exhibit 4.1 and Exhibit 4.2
hereto. The foregoing description of the Guaranties does not purport
to be complete and is qualified in its entirety by reference to the full text of
the form of Guaranty, which is incorporated by reference to the Company’s
current report on Form 8-K filed on July 9, 2010.
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Item
3.02
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Unregistered Sales of Equity
Securities.
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The
description of the Notes and the Warrants is incorporated herein by reference to
Item 2.03 hereof and the full text of the form of Note and form of Warrant
attached hereto as Exhibits 4.1 and 4.2. The Notes and Warrants were
issued by the Company under the exemption from registration afforded by Section
4(2) of the Securities Act of 1933, as amended, and Regulation D promulgated
thereunder, as they were issued to accredited investors, without a view to
distribution, and were not issued through any general solicitation or
advertisement.
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Financial Statements and
Exhibits.
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4.1
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Form of Unsecured Convertible
Promissory Note
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4.2
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Form of
Guaranty
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SIGNATURES
Pursuant
to the Securities Exchange Act of 1934, as amended, the registrant has duly
caused this report to be signed on its behalf by the undersigned hereunto duly
authorized.
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CNS
Response, Inc.
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By:
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/s/
Paul Buck
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August
24, 2010
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Paul
Buck
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Chief
FinancialOfficer
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