0001437749-18-022661.txt : 20181227 0001437749-18-022661.hdr.sgml : 20181227 20181227170223 ACCESSION NUMBER: 0001437749-18-022661 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181227 FILED AS OF DATE: 20181227 DATE AS OF CHANGE: 20181227 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: 181255200 MAIL ADDRESS: STREET 1: 2101 WEST COMMERCIAL BLVD. STREET 2: SUITE 3500 CITY: FORT LAUDERDALE STATE: FL ZIP: 33309 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 4 1 rdgdoc.xml FORM 4 X0306 4 2018-12-27 0001034592 OMNICOMM SYSTEMS INC OMCM 0001238906 WIT CORNELIS F 2101 W. COMMERCIAL BLVD. SUITE 3500 FORT LAUDERDALE FL 33309 1 1 1 Executive Chairman Common Stock 2018-12-27 4 M 0 2000000 0.25 A 51908050 I Trust Common Stock 200000 D Common Stock Warrant 0.25 2018-12-27 4 P 0 2000000 0.03 A 2018-12-27 2019-01-01 Common Stock 2000000 2000000 D Common Stock Warrant 0.25 2018-12-27 4 M 0 2000000 0.25 D 2018-12-27 2019-01-01 Common Stock 2000000 0 D On December 27, 2018, OmniCOmm Systems Inc. (the "Company") issued 2,000,000 shares of common stock to Mr. WIt upon the cash exercise of Warrants at an exercise price of $0.25. /s/ Cornelis F. Wit 2018-12-27