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<P style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>UNITED STATES</B></FONT></P>
<P style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>SECURITIES AND EXCHANGE COMMISSION</B></FONT></P>
<P id=PARA6 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>Washington, D.C. 20549</B></FONT></P>
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<P id=PARA10 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>FORM&nbsp;8-K</B></FONT></P>
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<P id=PARA14 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>CURRENT REPORT</B></FONT></P>
<P id=PARA15 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Pursuant to Section&nbsp;13 or 15(d)&nbsp;of</FONT> <FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">the Securities Exchange Act of 1934</FONT></P>
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<P id=PARA18 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Date of report (Date of earliest event reported):&nbsp;<B>November 19, 2015</B></FONT></P>
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<P id=PARA22 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 16pt; FONT-FAMILY: Times New Roman, Times, serif; COLOR: #000000"><FONT style="FONT-SIZE: 16pt; FONT-FAMILY: Times New Roman, Times, serif; COLOR: #000000"><B>OMNICOMM SYSTEMS, INC.</B></FONT></FONT><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"></FONT></P>
<P id=PARA23 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">(Exact Name of Registrant as Specified in its Charter)</FONT></P>
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<P id=PARA27 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>Delaware</B></FONT></P>
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<P id=PARA30 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>000-25203</B></FONT></P></TD>
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<P id=PARA31 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>11-3349762</B></FONT></P></TD></TR>
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<P id=PARA32 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">(Commission File Number)</FONT></P></TD>
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<P id=PARA36 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>2101 W. Commercial Blvd. Suite 3500, Ft.</B></FONT></P>
<P id=PARA37 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>Lauderdale, FL</B></FONT></P></TD>
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<P id=PARA38 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>33309</B></FONT></P></TD></TR>
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<P id=PARA39 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">(Address of Principal Executive Offices)</FONT></P></TD>
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<P id=PARA43 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Registrant&#8217;s telephone number, including area code:&nbsp;<B>(954)&nbsp;473-1254</B></FONT></P>
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<P id=PARA47 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Check the appropriate box below if the Form&nbsp;8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (<I>see</I> General Instruction A.2 below):</FONT></P>
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<P id=PARA54 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Soliciting material pursuant to Rule&nbsp;14a-12 under the Exchange Act (17 CFR 240.14a-12)</FONT></P></TD></TR></TABLE>
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<P id=PARA58 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Pre-commencement communications pursuant to Rule&nbsp;14d-2(b)&nbsp;under the Exchange Act (17 CFR 240.14d-2(b))</FONT></P></TD></TR></TABLE>
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<P id=PARA62 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Pre-commencement communications pursuant to Rule&nbsp;13e-4(c)&nbsp;under the Exchange Act (17 CFR 240.13e-4(c))</FONT></P></TD></TR></TABLE>
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<P id=PARA4 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>Item&nbsp;3.02 &#8211; </B><B>Unregist</B><B>ered Sales of Equity Securities.</B></FONT></P>
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<P id=PARA5 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">On November 19, 2015, OmniComm Systems, Inc. (the &#8220;Company&#8221;) issued 7,660,000 shares of common stock to Cornelis F. Wit, the Chief Executive Officer and Director of the Company (&#8220;Mr. Wit&#8221;), upon conversion of an aggregate principal amount of $1,915,000 convertible debentures at a conversion price of $.25 per share.</FONT></P>
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<P id=PARA7 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">On November 19, 2015, the Company issued 29,363,517 shares of common stock to Mr. Wit in exchange for the (1) satisfaction in full of an aggregate principal amount of $7,339,000 promissory notes and a convertible debenture, and (2) cancellation and termination of warrants exercisable into an aggregate amount of 29,363,517 shares of the Company&#8217;s common stock at an exercise price of $.25 per share.</FONT></P>
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<P id=PARA9 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">The issuances of the securities were deemed to be exempt from registration under the Securities Act of 1933, as amended (&#8220;Securities Act&#8221;) in reliance upon Section 4(a)(2) of the Securities Act, as transactions not involving any public offering, where the recipient of the securities was an accredited investor within the meaning of Rule 501 of Regulation D of the Securities Act who was acquiring the applicable securities for investment and not distribution and had represented that he could bear the risks of the investment. The recipient of securities in these transactions had adequate access, through employment to information about the Company. No underwriters were involved in the foregoing issuances of securities.</FONT></P>
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<P id=PARA79 style="TEXT-ALIGN: center; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif"><B>SIGNATURES</B></FONT></P>
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<P id=PARA81 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.</FONT></P>
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<P id=PARA85 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">OmniComm Systems, Inc.</FONT></P></FONT></FONT></TD>
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<P id=PARA84 style="TEXT-ALIGN: left; MARGIN: 0pt; LINE-HEIGHT: 1.25"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman, Times, serif">Date: November 20, 2015</FONT></P></FONT></TD>
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<TD style="BORDER-BOTTOM: #000000 1px solid" vAlign=top width="35%" noWrap align=left><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">/s/&nbsp;Thomas E. Vickers</FONT></TD>
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<TD vAlign=top width="35%"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Thomas E. Vickers</FONT></TD>
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<TD vAlign=top width="35%"><FONT style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Chief Accounting and Financial Officer</FONT></TD>
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omcm20130624_8k.htm
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of
the Securities Exchange Act of 1934
Date of report (Date of earliest event reported):
November 19, 2015
OMNICOMM SYSTEMS, INC.
(Exact Name of Registrant as Specified in its Charter)
Delaware
(State or Other Jurisdiction of Incorporation)
000-25203
11-3349762
(Commission File Number)
(IRS Employer Identification No.)
2101 W. Commercial Blvd. Suite 3500, Ft.
Lauderdale, FL
33309
(Address of Principal Executive Offices)
(Zip Code)
Registrant's telephone number, including area code:
(954) 473-1254
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (
see
General Instruction A.2 below):
☐
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
☐
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
☐
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
☐
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
Item 3.02 –
Unregist
ered Sales of Equity Securities.
On November 19, 2015, OmniComm Systems, Inc. (the "Company") issued 7,660,000 shares of common stock to Cornelis F. Wit, the Chief Executive Officer and Director of the Company ("Mr. Wit"), upon conversion of an aggregate principal amount of $1,915,000 convertible debentures at a conversion price of $.25 per share.
On November 19, 2015, the Company issued 29,363,517 shares of common stock to Mr. Wit in exchange for the (1) satisfaction in full of an aggregate principal amount of $7,339,000 promissory notes and a convertible debenture, and (2) cancellation and termination of warrants exercisable into an aggregate amount of 29,363,517 shares of the Company's common stock at an exercise price of $.25 per share.
The issuances of the securities were deemed to be exempt from registration under the Securities Act of 1933, as amended ("Securities Act") in reliance upon Section 4(a)(2) of the Securities Act, as transactions not involving any public offering, where the recipient of the securities was an accredited investor within the meaning of Rule 501 of Regulation D of the Securities Act who was acquiring the applicable securities for investment and not distribution and had represented that he could bear the risks of the investment. The recipient of securities in these transactions had adequate access, through employment to information about the Company. No underwriters were involved in the foregoing issuances of securities.
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
OmniComm Systems, Inc.
Date: November 20, 2015
By:
/s/ Thomas E. Vickers
Thomas E. Vickers
Chief Accounting and Financial Officer