0001185185-16-005963.txt : 20161216
0001185185-16-005963.hdr.sgml : 20161216
20161216132345
ACCESSION NUMBER: 0001185185-16-005963
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161214
FILED AS OF DATE: 20161216
DATE AS OF CHANGE: 20161216
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Spine Injury Solutions, Inc
CENTRAL INDEX KEY: 0001066764
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOSPITALS [8060]
IRS NUMBER: 980187705
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5225 KATY FREEWAY
STREET 2: SUITE 600
CITY: HOUSTON
STATE: TX
ZIP: 77007
BUSINESS PHONE: (713) 816-7303
MAIL ADDRESS:
STREET 1: 5225 KATY FREEWAY
STREET 2: SUITE 600
CITY: HOUSTON
STATE: TX
ZIP: 77007
FORMER COMPANY:
FORMER CONFORMED NAME: Spine Pain Management, Inc
DATE OF NAME CHANGE: 20091201
FORMER COMPANY:
FORMER CONFORMED NAME: VERSA CARD, INC.
DATE OF NAME CHANGE: 20080515
FORMER COMPANY:
FORMER CONFORMED NAME: Intrepid Global Imaging 3D, INC.
DATE OF NAME CHANGE: 20070319
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DONOVAN WILLIAM
CENTRAL INDEX KEY: 0001279311
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-27407
FILM NUMBER: 162055832
MAIL ADDRESS:
STREET 1: 903 CREEKWOOD WAY
CITY: HOUSTON
STATE: TX
ZIP: 77024
4
1
form4-donovan121616.xml
OWNERSHIP DOCUMENT
X0306
4
2016-12-14
0
0001066764
Spine Injury Solutions, Inc
SPIN
0001279311
DONOVAN WILLIAM
5225 KATY FREEWAY, SUITE 600
HOUSTON
TX
77007
1
1
1
0
CEO
Common Stock
2016-12-14
4
P
0
13211
0.20
A
3308152
D
Common Stock
2016-12-15
4
P
0
6789
0.20
A
3314941
D
/s/ William F. Donovan
2016-12-16