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