0001019687-15-004023.txt : 20151112 0001019687-15-004023.hdr.sgml : 20151112 20151112080818 ACCESSION NUMBER: 0001019687-15-004023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151102 FILED AS OF DATE: 20151112 DATE AS OF CHANGE: 20151112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Medytox Solutions, Inc. CENTRAL INDEX KEY: 0001374536 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TESTING LABORATORIES [8734] IRS NUMBER: 900902741 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 S. AUSTRALIAN AVENUE, SUITE 800 CITY: WEST PALM BEACH STATE: FL ZIP: 33401 BUSINESS PHONE: 561-855-1626 MAIL ADDRESS: STREET 1: 400 S. AUSTRALIAN AVENUE, SUITE 800 CITY: WEST PALM BEACH STATE: FL ZIP: 33401 FORMER COMPANY: FORMER CONFORMED NAME: CASINO PLAYERS, INC. DATE OF NAME CHANGE: 20060905 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FORHAN WILLIAM CENTRAL INDEX KEY: 0001274239 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54346 FILM NUMBER: 151221561 MAIL ADDRESS: STREET 1: 400 SOUTH AUSTRALIAN AVENUE STREET 2: 8TH FLOOR CITY: WEST PALM BEACH STATE: X1 ZIP: 33401 4 1 forhan_frm4.xml OWNERSHIP DOCUMENT X0306 4 2015-11-02 1 0001374536 Medytox Solutions, Inc. MMMS 0001274239 FORHAN WILLIAM 400 S. AUSTRALIAN AVENUE, SUITE 800 WEST PALM BEACH FL 33401 0 0 1 0 Common Stock 2015-11-02 4 D 0 1241551 D 0 D Options to Purchase Common Stock 2.50 2015-11-02 4 D 0 1000000 D 2012-10-01 2016-08-31 Common Stock 1000000 0 D Options to Purchase Common Stock 5.00 2015-11-02 4 D 0 1000000 D 2012-10-01 2016-08-31 Common Stock 1000000 0 D Options to Purchase Common Stock 10.00 2015-11-02 4 D 0 1000000 D 2012-10-01 2016-08-31 Common Stock 1000000 0 D Disposed of pursuant to merger agreement among Medytox Solutions, Inc. ("Medytox"), CollabRx Merger Sub, Inc. ("Merger Sub") and Rennova Health, Inc. ("Rennova") (f/k/a/ CollabRx, Inc.) in exchange for 508,587 shares of Rennova common stock. Cancelled pursuant to merger agreement and related transactions among Medytox , Merger Sub and Rennova. /s/ William G. Forhan 2015-11-12