0001493152-17-009525.txt : 20170817 0001493152-17-009525.hdr.sgml : 20170817 20170817113634 ACCESSION NUMBER: 0001493152-17-009525 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170815 FILED AS OF DATE: 20170817 DATE AS OF CHANGE: 20170817 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ajami Kamran CENTRAL INDEX KEY: 0001703668 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35141 FILM NUMBER: 171038018 MAIL ADDRESS: STREET 1: 3920 NW 43RD ST. CITY: COCONUT CREEK STATE: FL ZIP: 33073 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 4 1 form4.xml X0306 4 2017-08-15 0 0000931059 Rennova Health, Inc. RNVA 0001703668 Ajami Kamran 400 S. AUSTRALIAN AVE., SUITE 800 WEST PALM BEACH FL 33401 1 0 0 0 Restricted Stock 2017-08-15 4 A 0 100000 0 A 100000 D Common Stock 19240 D The grant of restricted stock of Rennova Health, Inc. (the "Company") vests in full on August 15, 2018, subject to the reporting person's continuing to be a director of the Company. /s/ Kamran Ajami 2017-08-17