SEC FORM 3 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*
D'Angelo Lauren

(Last) (First) (Middle)
C/O ALPHA COGNITION INC.
1200 - 750 WEST PENDER STREET

(Street)
VANCOUVER A1 V6C 2T8

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/12/2024
3. Issuer Name and Ticker or Trading Symbol
Alpha Cognition Inc. [ ACOG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Operating 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
Common Share Options 01/18/2023(1) 08/03/2031 Common Shares 24,000 $5.21(2) D
Common Share Options 01/18/2023(3) 02/14/2032 Common Shares 6,000 $5.21(2) D
Common Share Options 06/08/2023(4) 06/08/2033 Common Shares 158,000 $4.12(5) D
Explanation of Responses:
1. Options are fully vested.
2. Converted from Canadian exercise price of C$7.00 at C$1.3439=USD$1.00.
3. Options vest equally over 24 months, commencing on January 31, 2023.
4. 12.5% vested on June 8, 2023, and the remaining 87.5% vests in equal monthly installments until January 30, 2026.
5. Converted from Canadian exercise price of C$5.50 at C$1.3358=USD$1.00.
/s/ D'Angelo Lauren 11/12/2024
** 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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