0001683168-16-000090.txt : 20160913 0001683168-16-000090.hdr.sgml : 20160913 20160913162936 ACCESSION NUMBER: 0001683168-16-000090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160717 FILED AS OF DATE: 20160913 DATE AS OF CHANGE: 20160913 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: 161883113 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 2016-07-17 0 0000931059 Rennova Health, Inc. RNVA 0001575762 Mendolia Thomas Francis DO 400 S. AUSTRALIAN AVENUE, SUITE 800 WEST PALM BEACH, FL 33401 0 0 1 0 Options to Purchase Common Stock 0.30 2016-07-17 4 A 0 20000 0 A 2026-07-17 Common Stock 20000 20000 D The options vest as follows: 10,000 on July 17, 2016, 5,000 on September 30, 2016, and 5,000 on December 31, 2016, subject to the Reporting Person's attendance at meetings of the Issuer's scientific advisory committee. /s/ Thomas Francis Mendolia DO 2016-09-13