0001144204-14-059288.txt : 20141002 0001144204-14-059288.hdr.sgml : 20141002 20141002162756 ACCESSION NUMBER: 0001144204-14-059288 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141001 FILED AS OF DATE: 20141002 DATE AS OF CHANGE: 20141002 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Skyline Medical Inc. CENTRAL INDEX KEY: 0001446159 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 331007393 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2915 COMMERS DRIVE, STREET 2: SUITE 900 CITY: EAGAN STATE: MN ZIP: 55121 BUSINESS PHONE: 651-389-4800 MAIL ADDRESS: STREET 1: 2915 COMMERS DRIVE, STREET 2: SUITE 900 CITY: EAGAN STATE: MN ZIP: 55121 FORMER COMPANY: FORMER CONFORMED NAME: BioDrain Medical, Inc. DATE OF NAME CHANGE: 20080925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kornberg Joshua CENTRAL INDEX KEY: 0001545669 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54361 FILM NUMBER: 141136801 MAIL ADDRESS: STREET 1: 1 GRAND ARMY PLAZA STREET 2: #9F CITY: BROOKLYN STATE: NY ZIP: 11238 4 1 v390640_4.xml OWNERSHIP DOCUMENT X0306 4 2014-10-01 0 0001446159 Skyline Medical Inc. SKLN 0001545669 Kornberg Joshua 1 GRAND ARMY PLAZA #9F BROOKLYN NY 11217 1 1 1 0 CEO and President Non-qualified Stock Options 0.11 2014-10-01 4 A 0 45455 A 2014-10-01 2024-10-01 Common Stock, par value $0.01 per share 45455 22985709 D The grant of non-qualified stock options to Mr. Kornberg was made pursuant to a Stock Option Award Grant made under the Issuer's 2012 Stock Incentive Plan. /s/ Joshua Kornberg 2014-10-02