0001019687-16-006127.txt : 20160505 0001019687-16-006127.hdr.sgml : 20160505 20160505155116 ACCESSION NUMBER: 0001019687-16-006127 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160502 FILED AS OF DATE: 20160505 DATE AS OF CHANGE: 20160505 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: 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: 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: Mendolia Thomas Francis DO CENTRAL INDEX KEY: 0001575762 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35141 FILM NUMBER: 161623468 MAIL ADDRESS: STREET 1: 400 SOUTH AUSTRALIAN AVENUE STREET 2: 8TH FLOOR CITY: WEST PALM BEACH STATE: FL ZIP: 33401 4 1 mendolia_frm4.xml FORM 4 X0306 4 2016-05-02 1 0000931059 Rennova Health, Inc. RNVA 0001575762 Mendolia Thomas Francis DO 400 S. AUSTRALIAN AVENUE 8TH FLOOR WEST PALM BEACH FL 33401 0 0 1 0 Options to Purchase Common Stock 1.00 2016-05-02 4 A 0 20000 0 A 2026-05-02 Common Stock 20000 20000 D Options to Purchase Common Stock 5.00 2016-05-02 4 A 0 1000000 0 A 2016-05-02 2017-12-31 Common Stock 1000000 1000000 D Options to Purchase Common Stock 10.00 2016-05-02 4 A 0 1000000 0 A 2016-05-02 2022-12-31 Common Stock 1000000 1000000 D The options vest as follows: 5,000 upon date of grant, 5,000 on June 30, 2016, 5,000 on September 30, 2016, and 5,000 on December 31, 2016, subject to the Reporting Person's attendance at meetings of the Issuer's scientific advisory committee. /s/ Thomas Francis Mendolia 2016-05-05