SEC Form 4 · accession 0001683168-16-000087
Rennova Health, Inc. · RNVA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Francisco Roca III
10% Owner
Period of report
Aug 5, 2016
Accepted (ET)
Sep 13, 2016 · 4:26 pm EDT
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 | Aug 5, 2016 | J | 737,399 | $0.45 | A | 2,593,058 | D | |
| Series B Convertible Preferred Stock | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrants to Purchase Common StockF1 | $0.45 | Aug 5, 2016 | J | 737,399 | A | Aug 5, 2016 | Aug 5, 2026 | Common Stock | 737,399 | 737,399 | D |
Explanation of responses
- F1The Reporting Person received the shares and warrants in exchange for the cancellation of certain outstanding indebtedness.