-----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, KFb3eCaK9vm63hpQqwmKDsEshjruesmufeADUW4itr0IH4Lh8yc7qt3EJbb72Rsm SLVgJlYlwwICPJPmTX5+8Q== 0001144204-04-001522.txt : 20040213 0001144204-04-001522.hdr.sgml : 20040213 20040213182426 ACCESSION NUMBER: 0001144204-04-001522 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040211 FILED AS OF DATE: 20040213 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 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: 04601411 BUSINESS ADDRESS: STREET 1: INTELLICHECK INC STREET 2: 775 PARK AVE CITY: HUNTINGTON STATE: NY ZIP: 11743 BUSINESS PHONE: 5164212011 4 1 v01615_ex.xml X0201 4 2004-02-11 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 2004-02-11 4 G 0 5000 0 D 15600 I Spouse Rights 8.50 2004-02-11 4 D 0 500 0 D 2001-10-05 2004-06-30 Common Stock 500 0 I Spouse Rights 8.50 2001-12-13 4 A 0 1540 0 A 2001-12-13 2004-06-30 Common Stock 1540 1540 I Spouse These shares are owned by Mr. Mandelbaum's spouse. Mr. Mandelbaum disclaims beneficial ownership of these shares. Upon a transfer of shares to which the rights attach the rights are no longer exercisable. These rights attach to the shares owned by Mr. Mandelbaum's spouse. Mr. Mandelbaum disclaims beneficial ownership of these rights and the shares underlying them. /s/ Frank Mandelbaum 2004-02-13 -----END PRIVACY-ENHANCED MESSAGE-----