0001019687-15-004365.txt : 20151130
0001019687-15-004365.hdr.sgml : 20151130
20151130160412
ACCESSION NUMBER: 0001019687-15-004365
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151102
FILED AS OF DATE: 20151130
DATE AS OF CHANGE: 20151130
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: Lundberg George
CENTRAL INDEX KEY: 0001586076
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35141
FILM NUMBER: 151260005
MAIL ADDRESS:
STREET 1: 44 MONTGOMERY STREET
STREET 2: SUITE 800
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
4
1
lundberg_f4.xml
OWNERSHIP DOCUMENT
X0306
4
2015-11-02
1
0000931059
Rennova Health, Inc.
RNVA
0001586076
Lundberg George
400 S. AUSTRALIAN AVE., SUITE 800
WEST PALM BEACH
FL
33401
0
1
0
0
Editor in Chief and CMO
Common Stock
1000
D
Options to Purchase Common Stock
4.80
2015-11-02
4
A
0
60000
0
A
2016-11-02
2025-11-02
Common Stock
60000
60000
D
Options to Purchase Common Stock
39.40
2012-07-12
4
J
0
1500
A
2015-11-02
2022-07-12
Common Stock
1500
1500
D
Options to Purchase Common Stock
7.50
2014-12-08
4
J
0
500
A
2015-11-02
2024-12-08
Common Stock
500
500
D
Options to Purchase Common Stock
19.90
2014-07-03
4
J
0
450
A
2015-11-02
2024-07-03
Common Stock
450
450
D
Reflects the one-for-ten reverse stock split effectuated by Rennova Health, Inc. ("Rennova").
The Option shall vest with respect to fifty percent (50%) of the total number of shares of Common Stock (the "Shares") subject to the Option on the six-month anniversary of the date of grant, and the remaining fifty percent (50%) of the total number of Shares subject to the Option on the twelve-month anniversary, subject to the Reporting Person's continued status as an employee on each applicable vesting date, such that all Shares subject to the Option shall be fully vested on the first anniversary of the date of grant of the Option.
In connection with the merger transaction with Medytox Solutions, Inc., and the one-for-ten reverse stock split effectuated by Rennova, the Options, which were previously reported, have been adjusted to reflect accelerated vesting; an adjustment to the number of Options and the number of shares of common stock issuable upon exercise of the Options; and an adjustment to the exercise price as a consequence of the reverse split.
/s/ George Lundberg
2015-11-30