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