0001019687-15-004261.txt : 20151120
0001019687-15-004261.hdr.sgml : 20151120
20151120114524
ACCESSION NUMBER: 0001019687-15-004261
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151102
FILED AS OF DATE: 20151120
DATE AS OF CHANGE: 20151120
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: Frank Benjamin
CENTRAL INDEX KEY: 0001578755
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35141
FILM NUMBER: 151245634
MAIL ADDRESS:
STREET 1: 400 SOUTH AUSTRALIAN AVENUE
STREET 2: 8TH FLOOR
CITY: WEST PALM BEACH
STATE: FL
ZIP: 33401
3
1
frank_f3.xml
OWNERSHIP DOCUMENT
X0206
3
2015-11-02
0
0000931059
Rennova Health, Inc.
RNVA
0001578755
Frank Benjamin
400 S. AUSTRALIAN AVENUE, SUITE 800
WEST PALM BEACH
FL
33401
1
0
0
0
Options to Purchase Common Stock
6.11
2015-11-02
2017-04-19
Common Stock
40963
D
Options to Purchase Common Stock
6.11
2015-11-02
2017-04-19
Common Stock
20481
D
Received in connection with the merger transaction with Medytox Solutions, Inc. ("Medytox ") in exchange for the cancellation of options to acquire 100,000 shares of the common stock of Medytox at an exercise price of $2.50 per share, based upon an exchange ratio of 0.4096377408003329.
Received in connection with the merger transaction with Medytox in exchange for the cancellation of options to acquire 50,000 shares of the common stock of Medytox at an exercise price of $2.50 per share, based upon an exchange ratio of 0.4096377408003329.
/s/ Benjamin Frank
2015-11-19