SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF 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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1. Name and Address of Reporting Person*
AULT MILTON C III

(Last) (First) (Middle)
3802 SPECTRUM BOULEVARD, SUITE 112C

(Street)
TAMPA FL 33612

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/14/2021
3. Issuer Name and Ticker or Trading Symbol
Alzamend Neuro, Inc. [ ALZN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 10,000,000 I By Ault Life Sciences Fund, LLC(1)
Common Stock 3,094,555 I By Digital Power Lending, LLC(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants 04/30/2019 04/29/2024 Common Stock 5,000,000 3 I By Ault Life Sciences Fund, LLC(1)
Warrants 03/09/2021 03/08/2026 Common Stock 1,350,000 3 I By Digital Power Lending, LLC(2)
Series A Convertible Preferred Stock (3) (3) Common Stock 15,000,000 (3) I By Ault Life Sciences, Inc.
Stock Options (Right to Buy) (4) 04/29/2026 Common Stock 2,500,000 0.0004 D
Explanation of Responses:
1. Mr. Ault has sole voting and investment power with respect to the securities held of record by Ault Life Sciences Fund, LLC.
2. Digital Power Lending, LLC ("DPL") is a wholly-owned subsidiary of Ault Global Holdings, Inc. ("AGH") Mr. Ault, the Executive Chairman of AGH, is deemed to have voting and investment power with respect to the securities held of record by DPL.
3. The Series A Convertible Preferred Stock (the "Series A Preferred Stock") shall automatically convert into 15,000,000 shares of Common Stock upon the closing of the initial public offering without payment of further consideration. Mr. Ault has sole voting and investment power with respect to the shares of Series A Preferred Stock held of record by Ault Life Sciences, Inc.
4. Mr. Ault was granted stock options to purchase 2,500,000 shares of Common Stock, which options are exercisable at an exercise price of $0.004 and are currently vested and exercisable.
Remarks:
/s/ Milton C. Ault, III 06/14/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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