-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, BgEjObPhEbAcdDRAurPTf+4YSyjO/F5VRHsj8ig3EBgXa7K8cRLnhIF+V57TdxgT coz3CfXl/nhC1AdusEFsYQ== 0001144204-04-000013.txt : 20040102 0001144204-04-000013.hdr.sgml : 20040101 20040102163345 ACCESSION NUMBER: 0001144204-04-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031230 FILED AS OF DATE: 20040102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MANDELBAUM FRANK CENTRAL INDEX KEY: 0001099377 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50296 FILM NUMBER: 04501517 BUSINESS ADDRESS: STREET 1: INTELLICHECK INC STREET 2: 775 PARK AVE CITY: HUNTINGTON STATE: NY ZIP: 11743 BUSINESS PHONE: 5164212011 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INTELLI CHECK INC CENTRAL INDEX KEY: 0001040896 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 113234779 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 775 PARK AVE CITY: HUNTINGTON STATE: NY ZIP: 11743 BUSINESS PHONE: 5164212011 MAIL ADDRESS: STREET 1: 775 PARK AVENUE STREET 2: SUITE 340 CITY: HUNTINGTON STATE: NY ZIP: 11743 4 1 v01147_ex.xml X0201 4 2003-12-30 0 0001040896 INTELLI CHECK INC IDN 0001099377 MANDELBAUM FRANK 246 CROSSWAYS PARK WEST WOODBURY NY 11797 1 1 1 0 Chairman and CEO Common Stock, $.001 par value 2003-12-30 4 G 0 6000 0 D 569300 D Rights 8.50 2003-12-30 4 D 0 600 0 D 2001-10-05 2004-06-30 Common Stock 600 0 D Option (Right to Buy) 8.22 2003-07-10 4 A 0 100000 0 A 2003-07-10 2008-07-10 Common Stock 100000 100000 D Option (Right to Buy) 12.10 2002-02-01 4 A 0 350000 0 A 2002-02-01 2007-02-01 Common Stock 350000 350000 D Option (Right to Buy) 3.00 1999-08-04 4 A 0 25000 0 A 2000-01-01 2005-01-01 Common Stock 25000 25000 D Option (Right to Buy) 3.00 1999-08-04 4 A 0 25000 0 A 2001-01-01 2006-01-01 Common Stock 25000 25000 D Option (Right to Buy) 3.00 1999-08-04 4 A 0 25000 0 A 2002-01-01 2007-01-01 Common Stock 25000 25000 D Option (Right to Buy) 3.00 1999-07-15 4 A 0 375000 0 A 1999-07-15 2004-07-15 Common Stock 375000 375000 D Rights 8.50 2001-12-13 4 A 0 58000 0 A 2001-12-13 2004-06-30 Common Stock 58000 58000 D Rights 8.50 2001-10-05 4 A 0 43500 0 A 2001-10-05 2004-06-30 Common Stock 43500 43500 D Upon a transfer of shares to which the rights attach the rights are no longer exercisable. Of these options, 275,000 are exercisable of which 125,000 were granted pursuant to the Issuer's 2001 Stock Option Plan. The remaining 75,000 non-plan options will become exercisable on December 31, 2004. /s/ Frank Mandelbaum 2004-01-02 -----END PRIVACY-ENHANCED MESSAGE-----