0001437749-19-005201.txt : 20190318 0001437749-19-005201.hdr.sgml : 20190318 20190318171835 ACCESSION NUMBER: 0001437749-19-005201 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190314 FILED AS OF DATE: 20190318 DATE AS OF CHANGE: 20190318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Howells Keith L CENTRAL INDEX KEY: 0001708423 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25203 FILM NUMBER: 19689228 MAIL ADDRESS: STREET 1: 2101 W. COMMERCIAL BLVD #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 2019-03-14 0001034592 OMNICOMM SYSTEMS INC OMCM 0001708423 Howells Keith L 2101 W. COMMERCIAL BLVD. SUITE 3500 FORT LAUDERDALE FL 33309 1 Chief Technology Officer Common Stock 2019-03-14 4 A 0 225000 0.28 A 2586000 D Issued pursuant to the terms and conditions of the 2016 Equity Incentive Plan of OmniComm Systems, Inc. and held in escrow to be released ratably over on the first three anniversaries of the date of grant, subject to continued employment and the achievement of performance goals. The holder retains voting rights over all of the shares while in escrow. /s/ Keith L. Howells 2019-03-18