-----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, GwI3hFhVu0qjTnDXpUpvGIE9xXBMnNIoV/eH2dTaS/1h8M4DK55MGRBReUqvxTSO bz1spM5itwAK4rjRbxGY/g== 0001181431-10-001289.txt : 20100105 0001181431-10-001289.hdr.sgml : 20100105 20100105172202 ACCESSION NUMBER: 0001181431-10-001289 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091231 FILED AS OF DATE: 20100105 DATE AS OF CHANGE: 20100105 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: 10508308 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 rrd262029.xml FORM 4 X0303 4 2009-12-31 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 0.25 2009-12-31 4 P 0 5900000 0.25 A 2009-12-31 2011-06-30 Common Stock 5900000 41930000 D Common stock warrants 0.25 2009-12-31 4 P 0 5900000 0.25 A 2009-12-31 2013-12-31 Common Stock 5900000 47830000 D Employee stock options 0.20 2009-12-31 4 A 0 250000 0 A 2009-12-31 2014-12-31 Common Stock 250000 48080000 D /s/ Cornelis F. Wit 2009-12-31 -----END PRIVACY-ENHANCED MESSAGE-----