0001179110-16-022934.txt : 20160411 0001179110-16-022934.hdr.sgml : 20160411 20160411100138 ACCESSION NUMBER: 0001179110-16-022934 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160406 FILED AS OF DATE: 20160411 DATE AS OF CHANGE: 20160411 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: 001-36790 FILM NUMBER: 161564222 MAIL ADDRESS: STREET 1: 1 GRAND ARMY PLAZA STREET 2: #9F CITY: BROOKLYN STATE: NY ZIP: 11238 4 1 edgar.xml FORM 4 - X0306 4 2016-04-06 0 0001446159 Skyline Medical Inc. SKLN 0001545669 Kornberg Joshua 2915 COMMERS DRIVE, SUITE 900 EAGAN MN 55121 1 1 1 0 CEO and President Common Stock, $.01 par value 805982 I By SOK Partners LLC Common Stock, $.01 par value 615281 I By Atlantic Partners Alliance LLC Common Stock, $.01 par value 2016-04-06 4 C 0 2778 A 9739 D Series B Convertible Preferred Stock 2016-04-06 4 C 0 2778 0 A 2016-02-28 Common Stock, $.01 par value 2778 0 D A limited liability company of which the Reporting Person is one of the managers. The Reporting Person disclaims beneficial ownership of such shares, except for those as to which he may have a pecuniary interest therein. A limited liability company, of which the Reporting Person is a member. The Reporting Person disclaims beneficial ownership of such shares, except for those as to which he may have a pecuniary interest therein. Conversion of Series B Preferred Stock into shares of Common Stock on a one-for-one basis, pursuant to the terms of the Series B Preferred Stock. The transaction is exempt under Rule 16b-6(b). No expiration date. /s/ Joshua Kornberg 2016-04-08