-----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, QLHf/9oiTDhn9StmtV0yWIALl1IWxHPfjoaFmqj5fkTtd8b2BOLDfv7azvFIxfJD Tt8QgH5Ilb3Fl4lfulC0YQ== 0001181431-09-047171.txt : 20091007 0001181431-09-047171.hdr.sgml : 20091007 20091007203547 ACCESSION NUMBER: 0001181431-09-047171 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090930 FILED AS OF DATE: 20091007 DATE AS OF CHANGE: 20091007 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: 091110996 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 4 1 rrd254738.xml FORM 4 X0303 4 2009-09-30 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 Common Stock 2009-10-06 4 P 0 1000 0.24 A 3633044 D Convertible Debenture 0.25 2009-09-30 4 P 0 4400000 0 A 2009-09-30 2011-03-30 Common Stock 4400000 31630000 D Common Stock Warrant 0.25 2009-09-30 4 P 0 4400000 0 A 2009-09-30 2013-09-30 Common Stock 4400000 36030000 D /s/ Cornelis F. Wit 2009-10-07 -----END PRIVACY-ENHANCED MESSAGE-----