0001437749-16-034220.txt : 20160622 0001437749-16-034220.hdr.sgml : 20160622 20160622112136 ACCESSION NUMBER: 0001437749-16-034220 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160616 FILED AS OF DATE: 20160622 DATE AS OF CHANGE: 20160622 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: 2101 W COMMERCIAL BLVD. STREET 2: SUITE 3500 CITY: FORT LAUDERDALE STATE: FL ZIP: 33309 BUSINESS PHONE: 954-473-1254 MAIL ADDRESS: STREET 1: 2101 W COMMERCIAL BLVD. STREET 2: SUITE 3500 CITY: FORT LAUDERDALE STATE: FL ZIP: 33309 FORMER COMPANY: FORMER CONFORMED NAME: CORAL DEVELOPMENT CORP DATE OF NAME CHANGE: 19970225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cohen Adam F. CENTRAL INDEX KEY: 0001592382 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25203 FILM NUMBER: 161725973 MAIL ADDRESS: STREET 1: 2101 WEST COMMERICAL BLVD STREET 2: SUITE 3500 CITY: FORT LAUDERDALE STATE: FL ZIP: 33309 4 1 rdgdoc.xml FORM 4 X0306 4 2016-06-16 0001034592 OMNICOMM SYSTEMS INC OMCM 0001592382 Cohen Adam F. 2101 W. COMMERCIAL BLVD. SUITE 3500 FORT LAUDERDALE FL 33309 1 Common Stock 2016-06-16 4 A 0 120000 0.19 A 1130000 D Issued pursuant to the terms and conditions of the 2009 Equity Incentive Plan of OmniComm Systems, Inc. and held in escrow to be released ratable over a three year period conditioned upon continued service. Dr. Cohen retains voting rights over all the shares while in escrow. /s/ Adam F. Cohen 2016-06-22