0001683168-17-000394.txt : 20170216 0001683168-17-000394.hdr.sgml : 20170216 20170216145426 ACCESSION NUMBER: 0001683168-17-000394 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161115 FILED AS OF DATE: 20170216 DATE AS OF CHANGE: 20170216 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: Sramowicz Steven CENTRAL INDEX KEY: 0001575752 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35141 FILM NUMBER: 17617506 MAIL ADDRESS: STREET 1: 400 SOUTH AUSTRALIAN AVENUE STREET 2: 8TH FLOOR CITY: WEST PALM BEACH STATE: FL ZIP: 33401 4 1 sramowicz_f4-111516.xml OWNERSHIP DOCUMENT X0306 4 2016-11-15 0 0000931059 Rennova Health, Inc. RNVA 0001575752 Sramowicz Steven 400 S. AUSTRALIAN AVENUE, 8TH FLOOR WEST PALM BEACH FL 33401 0 0 1 0 Common Stock 2016-11-15 4 J 0 222222 0.45 A 3739847 D Warrants to Purchase Common Stock 0.45 2016-11-15 4 J 0 222222 0 A 2016-11-15 2026-11-15 Common Stock 222222 222222 D The Reporting Person received the shares and warrants in exchange for the cancellation of certain indebtedness. /s/ Steven Sramowicz 2017-02-16