Medina Daniel Form 3 MEDICAL INNOVATION / Daniel Medina ownership change

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Medina Daniel

(Last) (First) (Middle)

11561 E. BEVERLY BLVD.

(Street)

WHITTIER CA 90601

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
11/27/2018

3. Issuer Name and Ticker or Trading Symbol
MEDICAL INNOVATION HOLDINGS, INC. [ MIHI ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director	X	10% Owner
Officer (give title below)		Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	37,611	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Series "A" Convertible Preferred Shares	(1)	(1)	Common Stock	15(2)(3)	(2)	D
Series "A" Convertible Preferred Shares	(1)	(1)	Common Stock	20(2)	(2)	I	Jointly with Madhava Rao Mankal(4)

Explanation of Responses:

1. Not Applicable.

2. Each share of Series "A" Convertible Preferred Stock votes equivalent of the common stock - 1%. Due to administrative delays, the stock was not issued until December 21, 2018.

3. 15 shares via repossession under purchase default. Due to administrative delays, the stock was not issued until December 21, 2018.

4. Combined vote 50% effectively through the 20 Series "A" Convertible Preferred Shares.

	/s/ Daniel Medina	12/24/2018
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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