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*
Jackman Stephan

(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)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
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)
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
Stock Options (right to buy) (1) 11/18/2029 Common Stock 2,000,000 1.5 D
Stock Options (right to buy) (2) 11/15/2029 Common Stock 5,000,000 1 D
Explanation of Responses:
1. The Reporting Person's right to exercise this stock option is subject to contingent vesting based upon either (i) the successful achievement of stepped target closing prices on a national securities exchange for 90 consecutive trading days later than 180 days after our initial public offering of our common stock, or (ii) stepped target prices for a change in control transaction. Of this stock option, no shares of Common Stock are currently vested and exercisable.
2. Mr. Jackman was granted stock options (the "Options") to purchase 5,000,000 shares of the Issuer's Common Stock which Options are exercisable for a period of ten years beginning on November 16, 2018, at a per share price of $1.00, and vests as follows: (i) 3,000,000 shares of Common Stock will vest ratably over 48 months beginning on November 16, 2018; (ii) upon approval by the U.S. Food and Drug Administration ("FDA") of the New Drug Application ("NDA") for AL001, 1,000,000 shares of Common Stock will vest ratably over 36 months from November 1, 2018; and (iii) upon approval by the FDA of an NDA for AL002, 1,000,000 shares of Common Stock will vest ratably over 48 months from November 1, 2018. Of this stock option, 2,000,000 shares are currently vested and exercisable.
Remarks:
/s/ Stephan Jackman 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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