0001019687-15-004035.txt : 20151112
0001019687-15-004035.hdr.sgml : 20151112
20151112145435
ACCESSION NUMBER: 0001019687-15-004035
CONFORMED SUBMISSION TYPE: 3
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: Rennova Health, Inc.
CENTRAL INDEX KEY: 0000931059
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
IRS NUMBER: 680370244
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: 44 MONTGOMERY STREET, SUITE 800
STREET 2: 400 S. AUSTRALIAN AVENUE, SUITE 800
CITY: WEST PALM BEACH
STATE: FL
ZIP: 33401
BUSINESS PHONE: 561-855-1626
MAIL ADDRESS:
STREET 1: 44 MONTGOMERY STREET, SUITE 800
STREET 2: 400 S. AUSTRALIAN AVENUE, SUITE 800
CITY: WEST PALM BEACH
STATE: FL
ZIP: 33401
FORMER COMPANY:
FORMER CONFORMED NAME: CollabRx, Inc.
DATE OF NAME CHANGE: 20120926
FORMER COMPANY:
FORMER CONFORMED NAME: TEGAL CORP /DE/
DATE OF NAME CHANGE: 19950918
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Roca Francisco III
CENTRAL INDEX KEY: 0001575722
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35141
FILM NUMBER: 151223720
MAIL ADDRESS:
STREET 1: 400 SOUTH AUSTRALIAN AVENUE
STREET 2: 8TH FLOOR
CITY: WEST PALM BEACH
STATE: FL
ZIP: 33401
3
1
roca_frm3.xml
FORM 3
X0206
3
2015-11-02
0
0000931059
Rennova Health, Inc.
RNVA
0001575722
Roca Francisco III
400 S. AUSTRALIAN AVENUE, SUITE 800
WEST PALM BEACH
FL
33401
0
0
1
0
Common Stock
1855659
D
Series B Convertible Preferred Stock
1000
D
Received in connection with the merger transaction with Medytox Solutions, Inc. ("Medytox"), in exchange for 4,530,000 shares of Medytox common stock, based upon an exchange ratio of 0.4096377408003329 per share.
Received in connection with the merger transaction with Medytox in exchange for 1,000 shares of Medytox Series B Preferred Stock.
/s/ Francisco Roca III
2015-11-12