Statement of Changes in Beneficial Ownership (4)
September 30 2021 - 04:16PM
Edgar (US Regulatory)
FORM 4
[X] Check this box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. See Instruction
1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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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 * Diamantis Christopher
Eric |
2. Issuer Name and Ticker or Trading
Symbol Rennova Health, Inc. [ RNVA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
_____ Officer (give title
below) __X__
Other (specify below)
Former 10% Owner |
(Last)
(First)
(Middle)
1143 GLENDALE LANE |
3. Date of Earliest Transaction (MM/DD/YYYY)
9/17/2021
|
(Street)
NASHVILLE, TN 37204
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock (1) |
|
|
|
|
|
|
|
95450000 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Warrants to Purchase Common
Stock |
$0.007 |
|
|
|
|
|
|
8/27/2021 (2) |
8/27/2024 |
Common Stock |
47500000 |
|
47500000 |
D |
|
Series M Convertible Redeemable Preferred
Stock |
(3) |
|
|
|
|
|
|
(2) |
(2) |
Common Stock |
(3) |
|
20180 |
D |
|
Explanation of
Responses: |
(1) |
This Form 4 is being filed
to reflect the fact that, as of September 17, 2021, Mr. Diamantis
beneficially owned less than 10% of the Common Stock of the Issuer.
Mr. Diamantis has not effected any transactions in the securities
of the Issuer since the August 27, 2021 Exchange Agreement reported
on his prior Form 4. Due to conversions of the Issuer's preferred
stock by parties other than Mr. Diamantis, the Issuer's outstanding
Common Stock has increased dramatically. As of September 17, 2021,
there were 1,057,349,999 shares of Common Stock issued and
outstanding and, as a result, Mr. Diamantis' beneficial ownership
has decreased to below 10%. |
(2) |
The exercise of the Warrants
and the conversion of the Series M Convertible Redeemable Preferred
Stock (the "Series M Preferred Stock") are each subject to
ownership blockers of 4.99%. As a result, they are not exercisable
or convertible as of September 17, 2021. The Series M Preferred
Stock has no stated maturity date. |
(3) |
The conversion price of the
Series M Preferred Stock fluctuates with the price of the Common
Stock. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Diamantis Christopher Eric
1143 GLENDALE LANE
NASHVILLE, TN 37204 |
|
|
|
Former 10% Owner |
Signatures
|
/s/ Christopher E. Diamantis |
|
9/30/2021 |
**Signature of
Reporting Person |
Date |
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