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