Statement of Changes in Beneficial Ownership (4)
19 October 2021 - 8:01AM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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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1. Name and Address of Reporting Person
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GUSTAFSON MARK |
2. Issuer Name and Ticker or Trading Symbol
Alzamend Neuro, Inc.
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ALZN
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
3802 SPECTRUM BOULEVARD, SUITE 112C |
3. Date of Earliest Transaction
(MM/DD/YYYY)
10/15/2021 |
(Street)
TAMPA, FL 33612
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 10/15/2021 | | M(1) | | 47222 | A | $0 | 50000 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Grant | (2) | 10/15/2021 | | M | | | 47222 | (3) | 3/15/2022 | Common Stock | 47222 | $0 | 50000 | D | |
Explanation of Responses: |
(1) | Represents the vesting of restricted stock. |
(2) | Each restricted stock unit is the economic equivalent of one share of Common Stock, par value $0.0001, of Alzamend Neuro, Inc. |
(3) | The restricted stock grant was amended on October 13, 2021, such that 47,222 shares of restricted stock vested on October 15, 2021, and the remaining 50,000 shares of restricted stock shall vest on March 15, 2022. 2,778 shares previously vested on September 13, 2021. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GUSTAFSON MARK 3802 SPECTRUM BOULEVARD, SUITE 112C TAMPA, FL 33612 | X |
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Signatures
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/s/ Mark Gustafson | | 10/18/2021 |
**Signature of Reporting Person | Date |
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