SEC Form 4 · accession 0001437749-15-021477
OMNICOMM SYSTEMS INC · OMCM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Cornelis F Wit
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Nov 23, 2015
Accepted (ET)
Nov 25, 2015 · 2:29 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001034592
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible DebtF1 | $0.25 | Nov 23, 2015 | S | — | D | Sep 30, 2009 | Nov 23, 2015 | Common Stock | 2,500,000 | 0 | D |
| Common Stock Warrant | $0.25 | Nov 23, 2015 | S | 4,000,000 | D | Oct 15, 2015 | Nov 23, 2015 | Common Stock | 4,000,000 | 2,000,000 | D |
| Common Stock WarrantF1 | $0.25 | Nov 23, 2015 | S | 2,500,000 | D | Sep 30, 2009 | Nov 23, 2015 | Common Stock | 2,500,000 | 0 | D |
Explanation of responses
- F1The Reporting Person sold the Common Stock Warrants and Convertible Debt for a total consideration of $656,250.