0001437749-19-006462.txt : 20190403
0001437749-19-006462.hdr.sgml : 20190403
20190403142043
ACCESSION NUMBER: 0001437749-19-006462
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190401
FILED AS OF DATE: 20190403
DATE AS OF CHANGE: 20190403
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: 19728558
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
2019-04-01
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
2019-04-01
4
O
0
800000
0.25
A
52708050
I
Trust
Common Stock
125000
D
Common Stock Warrant
0.25
2019-04-01
4
O
0
800000
0.25
D
2016-02-29
2019-04-01
Common Stock
800000
0
D
On April 1, 2019, OmniComm Systems Inc. (the "Company") issued 800,000 shares of common stock to Mr. Wit upon the cash exercise of Warrants at an exercise price of $.025.
/s/ Cornelis F. Wit
2019-04-03