0001019687-16-007307.txt : 20160818
0001019687-16-007307.hdr.sgml : 20160818
20160818172735
ACCESSION NUMBER: 0001019687-16-007307
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160717
FILED AS OF DATE: 20160818
DATE AS OF CHANGE: 20160818
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: Goldberg Michael Louis
CENTRAL INDEX KEY: 0001370616
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35141
FILM NUMBER: 161841591
MAIL ADDRESS:
STREET 1: 2008 BAYVIEW DRIVE
CITY: FORT LAUDERDALE
STATE: FL
ZIP: 33305
4
1
goldberg_f4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-07-17
0
0000931059
Rennova Health, Inc.
RNVA
0001370616
Goldberg Michael Louis
400 S. AUSTRALIAN AVE., SUITE 800
WEST PALM BEACH
FL
33401
1
0
0
0
Common Stock
2016-08-05
4
J
0
26667
.30
A
26667
I
By: Monarch Capital LLC
Common Stock
7110
D
Options to Purchase Common Stock
0.30
2016-07-17
4
A
0
300000
0
A
2026-07-17
Common Stock
300000
300000
D
The Reporting Person received the shares in exchange for the cancellation of outstanding consulting fees.
The options vest as follows: 100,000 on July 17, 2016; and 200,000 on December 31, 2016.
/s/ Michael L. Goldberg
2016-08-18