0001437749-19-012054.txt : 20190614 0001437749-19-012054.hdr.sgml : 20190614 20190614141446 ACCESSION NUMBER: 0001437749-19-012054 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190613 FILED AS OF DATE: 20190614 DATE AS OF CHANGE: 20190614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shangold Gary A CENTRAL INDEX KEY: 0001303697 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25203 FILM NUMBER: 19898483 MAIL ADDRESS: STREET 1: C/O NOVADEL PHARMA INC STREET 2: 25 MINNEAKONING ROAD CITY: FLEMINGTON STATE: NJ ZIP: 08822 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 2019-06-13 0001034592 OMNICOMM SYSTEMS INC OMCM 0001303697 Shangold Gary A 2101 W. COMMERCIAL BLVD. SUITE 3500 FORT LAUDERDALE FL 33309 1 Common Stock 2019-06-13 4 A 0 200000 0.25 A 665000 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 one day prior to the 2020 Annual Stockholder Meeting, subject to continued service and the achievement of performance goals. The holder retains voting rights over all of the shares while in escrow. /s/ Gary A. Shangold 2019-06-14