0001019687-15-004366.txt : 20151130 0001019687-15-004366.hdr.sgml : 20151130 20151130160447 ACCESSION NUMBER: 0001019687-15-004366 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: Vidwans Smruti J. CENTRAL INDEX KEY: 0001638804 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35141 FILM NUMBER: 151260012 MAIL ADDRESS: STREET 1: 44 MONTGOMERY STREET STREET 2: SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 4 1 vidwans_f4.xml OWNERSHIP DOCUMENT X0306 4 2015-11-02 1 0000931059 Rennova Health, Inc. RNVA 0001638804 Vidwans Smruti J. 400 S. AUSTRALIAN AVE., SUITE 800 WEST PALM BEACH FL 33401 0 1 0 0 Chief Science Officer Common Stock 1000 D Options to Purchase Common Stock 4.80 2015-11-02 4 A 0 120000 0 A 2016-11-02 2025-11-02 Common Stock 120000 120000 D Options to Purchase Common Stock 39.40 2012-07-12 4 J 0 3000 A 2015-11-02 2022-07-12 Common Stock 3000 3000 D Options to Purchase Common Stock 7.50 2014-12-08 4 J 0 1000 A 2015-11-02 2024-12-08 Common Stock 1000 1000 D Options to Purchase Common Stock 19.90 2014-07-03 4 J 0 1200 A 2015-11-02 2024-07-03 Common Stock 1200 1200 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/ Smruti Vidwans 2015-11-30