0001019687-16-007361.txt : 20160825
0001019687-16-007361.hdr.sgml : 20160825
20160825132049
ACCESSION NUMBER: 0001019687-16-007361
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160805
FILED AS OF DATE: 20160825
DATE AS OF CHANGE: 20160825
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Rennova Health, Inc.
CENTRAL INDEX KEY: 0000931059
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TESTING LABORATORIES [8734]
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: 161850979
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
2016-08-05
0
0000931059
Rennova Health, Inc.
RNVA
0001575762
Mendolia Thomas Francis DO
116 QUINCY COURT
MOORESVILLE
NC
28117
0
0
1
0
Common Stock
2016-08-05
4
J
0
737399
0.45
A
2593058
D
Series B Convertible Preferred Stock
1000
D
Warrants to Purchase Common Stock
0.45
2016-08-05
4
J
0
737399
0
A
2016-08-05
2026-08-05
Common Stock
737399
737399
D
The Reporting Person received the shares and warrants in exchange for the cancellation of certain outstanding indebtedness.
/s/ Thomas Francis Mendolia DO
2016-08-25