SEC Form 4 · accession 0001019687-15-004366
Rennova Health, Inc. · RNVA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Smruti J. Vidwans
Officer — Chief Science Officer
Period of report
Nov 2, 2015
Accepted (ET)
Nov 30, 2015 · 4:04 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000931059
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 1,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options to Purchase Common StockF2 | $4.80 | Nov 2, 2015 | A | 120,000 | A | Nov 2, 2016 | Nov 2, 2025 | Common Stock | 120,000 | 120,000 | D |
| Options to Purchase Common StockF3 | $39.40 | Jul 12, 2012 | J | 3,000 | A | Nov 2, 2015 | Jul 12, 2022 | Common Stock | 3,000 | 3,000 | D |
| Options to Purchase Common StockF3 | $7.50 | Dec 8, 2014 | J | 1,000 | A | Nov 2, 2015 | Dec 8, 2024 | Common Stock | 1,000 | 1,000 | D |
| Options to Purchase Common StockF3 | $19.90 | Jul 3, 2014 | J | 1,200 | A | Nov 2, 2015 | Jul 3, 2024 | Common Stock | 1,200 | 1,200 | D |
Explanation of responses
- F1Reflects the one-for-ten reverse stock split effectuated by Rennova Health, Inc. ("Rennova").
- F2The Option shall vest with respect to fifty percent (50%) of the total number of shares of Common Stock (the "Shares") subject to the Option on the six-month anniversary of the date of grant, and the remaining fifty percent (50%) of the total number of Shares subject to the Option on the twelve-month anniversary, subject to the Reporting Person's continued status as an employee on each applicable vesting date, such that all Shares subject to the Option shall be fully vested on the first anniversary of the date of grant of the Option.
- F3In connection with the merger transaction with Medytox Solutions, Inc., and the one-for-ten reverse stock split effectuated by Rennova, the Options, which were previously reported, have been adjusted to reflect accelerated vesting; an adjustment to the number of Options and the number of shares of common stock issuable upon exercise of the Options; and an adjustment to the exercise price as a consequence of the reverse split.