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Form C: Filer Information

Filer CIK:
0001729427 
Filer CCC:
XXXXXXXX 
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Form C: Issuer Information

Issuer Information

Name of Issuer:

CNS Pharmaceuticals, Inc. 

Legal Status of Issuer:

Form:

Corporation 

Jurisdiction of Incorporation/Organization:

NEVADA  

Date of Incorporation/Organization:

07-27-2017 

Physical Address of Issuer:

Address 1:

2100 WEST LOOP SOUTH 

Address 2:

SUITE 900 

City:

HOUSTON 

State/Country:

TEXAS  

Mailing Zip/Postal Code:

77027 

Website of Issuer:

www.cnspharma.com 

Form C: Offering Information

Offering Information

Form C: Annual Report Disclosure Requirements

Annual Report Disclosure Requirements

Form C: Signature

Signature

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), the issuer certifies that it has reasonable grounds to believe that it meets all of the requirements for filing on Form C and has duly caused this Form to be signed on its behalf by the duly authorized undersigned.

Issuer:

/s/ John Climaco 

Signature:

John Climaco 

Title:

Chief Executive Officer 

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

/s/ John Climaco 

Title:

President, Chief Executive Officer and Director 

Date:

04-24-2020 

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

/s/ Christopher Downs 

Title:

Chief Financial Officer 

Date:

04-24-2020 

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

/s/ Jerzy (George) Gumulka 

Title:

Director 

Date:

04-24-2020 

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

/s/ Carl Evans 

Title:

Director 

Date:

04-24-2020 

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

/s/ Jeffry Keyes 

Title:

Director 

Date:

04-24-2020 

Pursuant to the requirements of Sections 4(a)(6) and 4A of the Securities Act of 1933 and Regulation Crowdfunding (§ 227.100-503), this Form C has been signed by the following persons in the capacities and on the dates indicated.

Signature:

/s/ Andrzej Andraczke 

Title:

Director 

Date:

04-24-2020