-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DSumrRRTiu8lff34tN4Ft6pHsfrTtIpopURoNcYS9JiyxqUJEgCZq3fkRmyzfhTK +iMrJKY3XaW+PclqKelkig== 0001181431-08-050921.txt : 20080902 0001181431-08-050921.hdr.sgml : 20080901 20080902125908 ACCESSION NUMBER: 0001181431-08-050921 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080829 FILED AS OF DATE: 20080902 DATE AS OF CHANGE: 20080902 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: OMNICOMM SYSTEMS INC CENTRAL INDEX KEY: 0001034592 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 113349762 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2555 DAVIE ROAD STREET 2: SUITE 110-B CITY: FORT LAUDERDALE STATE: FL ZIP: 33317 BUSINESS PHONE: 954-473-1254 MAIL ADDRESS: STREET 1: 2555 DAVIE ROAD STREET 2: SUITE 110-B CITY: DAVIE STATE: FL ZIP: 33317 FORMER COMPANY: FORMER CONFORMED NAME: CORAL DEVELOPMENT CORP DATE OF NAME CHANGE: 19970225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WIT CORNELIS F CENTRAL INDEX KEY: 0001238906 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25203 FILM NUMBER: 081051021 BUSINESS ADDRESS: STREET 1: OMNI COMM SYSTEMS INC STREET 2: 2555 DAVIES ROAD STE 110-B CITY: DAVIE STATE: FL ZIP: 33317 BUSINESS PHONE: 9544731254 4 1 rrd217502.xml FORM 4 X0303 4 2008-08-29 0 0001034592 OMNICOMM SYSTEMS INC OMCM 0001238906 WIT CORNELIS F 2101 W. COMMERCIAL BLVD SUITE 4000 FORT LAUDERDALE FL 33309 1 1 0 0 President and CEO Convertible Debenture 0.50 2008-08-29 4 P 0 47899 0 A 2008-08-29 2008-12-01 Common Stock 47899 3136724 D Common Stock Warrant 0.60 2008-08-29 4 P 0 35924 0 A 2008-02-29 2012-02-29 Common Stock 35924 3172648 D Convertible Note 0.50 2008-08-29 4 P 0 3120000 0 A 2008-08-29 2010-08-29 Common Stock 3120000 6292648 D Common Stock Warrant 0.60 2008-08-29 4 P 0 3120000 0 A 2008-08-29 2012-08-29 Common Stock 3120000 9412648 D Common Stock Warrant 0.60 2008-08-29 4 P 0 300000 0 A 2008-08-29 2012-08-29 Common Stock 300000 9712648 D Convertible Note 0.50 2008-08-29 4 P 0 67058 0 A 2008-08-29 2009-06-02 Common Stock 67058 9779706 D Common Stock Warrant 0.60 2008-08-29 4 P 0 50294 0 A 2008-08-29 2012-06-02 Common Stock 50294 9830000 D The Conversion price of the Convertible Debenture was changed from $0.595 per share to $0.50 per share. The exercise of the original warrant issued was changed from $0.75 per share to $0.60 per share. Mr. Wit was granted additional warrants in connection with the extension of the Convertible Debenture. /s/ Cornelis F. Wit 2008-09-02 -----END PRIVACY-ENHANCED MESSAGE-----