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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) | ||
| 1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Options to Purchase Common Stock | $ 1.09 | 08/08/2007 | A | 968,889 | (1) | 08/08/2017 | Common Stock | 968,889 | $ 0 | 968,889 | D | ||||
| Options to Purchase Common Stock | $ 1.2 | 08/08/2007 | A | 333,611 | (2) | 08/08/2012 | Common Stock | 333,611 | $ 0 | 333,611 | D | ||||
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| Brandt Leonard J C/O CNS RESPONSE, INC. 2755 BRISTOL STREET COSTA MESA, CA 92626 |
X | X | President, CEO & Secretary | |
| /s/ Leonard J. Brandt | 08/10/2007 | |
| **Signature of Reporting Person | Date |
| * | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
| ** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
| (1) | A total of 269,357 options vested on the date of grant, 27,135 options vest on each of August 31, September 30, October 31, November 30 and December 31, 2007, and the remaining options shall vest in equal monthly installments of approximately 20,138 options beginning on January 31, 2007 and thereafter through April 30, 2010. |
| (2) | A total of 83,403 options vested on the grant date, and the remaining options shall vest in equal monthly installments of approximately 6,950 options beginning on January 31, 2007 and thereafter through December 31, 2010. |