SEC Form 4 · accession 0001019687-16-006127
Rennova Health, Inc. · RNVA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas Francis DO Mendolia
10% Owner
Period of report
May 2, 2016
Accepted (ET)
May 5, 2016 · 3:51 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000931059
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options to Purchase Common StockF1 | $1.00 | May 2, 2016 | A | 20,000 | A | — | May 2, 2026 | Common Stock | 20,000 | 20,000 | D |
| Options to Purchase Common Stock | $5.00 | May 2, 2016 | A | 1,000,000 | A | May 2, 2016 | Dec 31, 2017 | Common Stock | 1,000,000 | 1,000,000 | D |
| Options to Purchase Common Stock | $10.00 | May 2, 2016 | A | 1,000,000 | A | May 2, 2016 | Dec 31, 2022 | Common Stock | 1,000,000 | 1,000,000 | D |
Explanation of responses
- F1The options vest as follows: 5,000 upon date of grant, 5,000 on June 30, 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.