0001019687-16-006198.txt : 20160510 0001019687-16-006198.hdr.sgml : 20160510 20160510165112 ACCESSION NUMBER: 0001019687-16-006198 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151102 FILED AS OF DATE: 20160510 DATE AS OF CHANGE: 20160510 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: Sramowicz Steven CENTRAL INDEX KEY: 0001575752 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35141 FILM NUMBER: 161636475 MAIL ADDRESS: STREET 1: 400 SOUTH AUSTRALIAN AVENUE STREET 2: 8TH FLOOR CITY: WEST PALM BEACH STATE: FL ZIP: 33401 3 1 sramowicz_f3-051016.xml OWNERSHIP DOCUMENT X0206 3 2015-11-02 0 0000931059 Rennova Health, Inc. RNVA 0001575752 Sramowicz Steven 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/ Steven Sramowicz 2016-05-10