0001596771-19-000130.txt : 20191107 0001596771-19-000130.hdr.sgml : 20191107 20191107091053 ACCESSION NUMBER: 0001596771-19-000130 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191107 DATE AS OF CHANGE: 20191107 EFFECTIVENESS DATE: 20191107 FILER: COMPANY DATA: COMPANY CONFORMED NAME: NEUROONE MEDICAL TECHNOLOGIES Corp CENTRAL INDEX KEY: 0001500198 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 270863354 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-352808 FILM NUMBER: 191198357 BUSINESS ADDRESS: STREET 1: 7599 ANAGRAM DR CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: (952) 426-1383 MAIL ADDRESS: STREET 1: 7599 ANAGRAM DR CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 FORMER COMPANY: FORMER CONFORMED NAME: Original Source Entertainment, Inc. DATE OF NAME CHANGE: 20100830 D 1 primary_doc.xml X0708 D LIVE 0001500198 NEUROONE MEDICAL TECHNOLOGIES Corp 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 (952) 426-1383 DELAWARE Original Source Entertainment, Inc. Corporation true David A. Rosa 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 Executive Officer Director Mark Christianson 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 Executive Officer Steve Mertens 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 Executive Officer Paul Buckman 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 Director Suraj Kalia 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 Director Jeffrey S. Mathiesen 7599 Anagram Dr. Eden Prairie MN MINNESOTA 55344 Director Biotechnology Decline to Disclose 06b false 2019-11-01 false true true true true false 25000 Paulson Investment Company 5670 None None 40 Wall Street 39th Floor New York NY NEW YORK 10005 All States false 3000000 1253000 1747000 false 16 240000 true 0 The placement agent will receive a cash commission equal to 12% of the gross proceeds from the sale of the notes, and warrants to purchase common stock in an amount to equal 15% of the number of shares of common stock into which the notes are convertible. 976000 true The proceeds of this private placement, along with proceeds from other financings, may be used to pay certain executive officers and directors. false NEUROONE MEDICAL TECHNOLOGIES Corp /s/ David A. Rosa David A. Rosa President and CEO 2019-11-07