Statement of Changes in Beneficial Ownership (4)
July 25 2018 - 4:31PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Lagan Seamus
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2. Issuer Name
and
Ticker or Trading Symbol
Rennova Health, Inc.
[
RNVA
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
CEO and President
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(Last)
(First)
(Middle)
400 S. AUSTRALIAN AVE.,, SUITE 800
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3. Date of Earliest Transaction
(MM/DD/YYYY)
7/23/2018
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(Street)
WEST PALM BEACH,, FL 33401
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
_
X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Series J Convertible Preferred Stock
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$.0017
(1)
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7/23/2018
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A
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250000
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7/23/2018
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(5)
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Common Stock
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147058824
(2)
(3)
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$1.00
(4)
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250000
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I
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By: Alcimede LLC
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Explanation of Responses:
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(1)
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As of July 23, 2018. The conversion price equals the average closing price of the common stock for the 10 trading days prior to the conversion date.
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(2)
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Based on the conversion price as of July 23, 2018.
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(3)
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Each share of the Series J Convertible Preferred Stock has the number of votes equal to the number of shares of common stock into which it is convertible, except that, for certain specified matters, through September 30, 2018 only each share has 12,000 votes.
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(4)
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Alcimede LLC received the shares in exchange for the cancellation of outstanding debt.
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(5)
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The Series J Preferred Stock will remain outstanding until either converted or redeemed by the Company.
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Remarks:
Exhibit List - Exhibit 99 - Joint Filer Information
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Lagan Seamus
400 S. AUSTRALIAN AVE.,
SUITE 800
WEST PALM BEACH,, FL 33401
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X
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CEO and President
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Alcimede LLC
400 S. AUSTRALIAN AVE.,
SUITE 800
WEST PALM BEACH,, FL 33401
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Affiliated
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Signatures
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/s/ Seamus Lagan
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7/25/2018
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**
Signature of Reporting Person
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Date
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Alcimede LLC By: /s/ Seamus Lagan, Sole Manager
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7/25/2018
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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