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