-----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, Wpl2oHoFdJBC3urYWU9liAx6M6/PIyFr2fQh9ULYuu9YE6sVifNcOHqZU23Eh7/n /13dZjzTFo9FVDpfCqWI7Q== 0001144204-04-021210.txt : 20041207 0001144204-04-021210.hdr.sgml : 20041207 20041207162207 ACCESSION NUMBER: 0001144204-04-021210 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041201 FILED AS OF DATE: 20041207 DATE AS OF CHANGE: 20041207 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: 246 CROSSWAYS PARK WEST STREET 2: . CITY: WOODBURY STATE: NY ZIP: 11797 BUSINESS PHONE: 516-992-1900 MAIL ADDRESS: STREET 1: 246 CROSSWAYS PARK WEST STREET 2: . CITY: WOODBURY STATE: NY ZIP: 11797 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEVY JEFFREY CENTRAL INDEX KEY: 0001197704 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50296 FILM NUMBER: 041188690 BUSINESS ADDRESS: BUSINESS PHONE: 5169921900 MAIL ADDRESS: STREET 1: 4212 PICKERING PLACE CITY: ALEXANDRIA STATE: VA ZIP: 22309 4 1 v09657_levyex.xml X0202 4 2004-12-01 0 0001040896 INTELLI CHECK INC IDN 0001197704 LEVY JEFFREY 4212 PICKERING PLACE ALEXANDRIA VA 22309 1 0 0 0 Common Stock, $.001 par value 2004-12-01 4 P 0 500 3.91 A 2400 D Option (Right to Buy) 5.25 2004-07-08 4 A 0 4000 0 A 2004-07-08 2014-07-08 Common Stock 4000 4000 D Option (Right to Buy) 8.22 2003-07-10 4 A 0 79000 0 A 2003-07-10 2008-07-10 Common Stock 79000 79000 D Option (Right to Buy) 2.80 2002-07-15 4 A 0 3000 0 A 2002-07-15 2007-07-15 Common Stock 3000 3000 D Option (Right to Buy) 11.625 1999-12-13 4 A 0 15000 0 A 1999-12-13 2004-12-13 Common Stock 15000 15000 D Option (Right to Buy) 12.125 2000-03-13 4 A 0 2500 0 A 2000-03-13 2005-03-13 Common Stock 2500 2500 D Option (Right to Buy) 8.00 2000-05-08 4 A 0 1500 0 A 2000-05-08 2005-05-08 Common Stock 1500 1500 D Option (Right to Buy) 8.75 2000-07-13 4 A 0 30000 0 A 2001-07-13 2007-07-13 Common Stock 30000 30000 D Option (Right to Buy) 8.75 2000-07-13 4 A 0 5500 0 A 2000-07-13 2005-07-13 Common Stock 5500 5500 D Option (Right to Buy) 10.15 2001-07-11 4 A 0 5500 0 A 2001-07-11 2006-07-11 Common Stock 5500 5500 D Option (Right to Buy) 6.22 2003-03-17 4 A 0 1000 0 A 2003-03-17 2008-03-17 Common Stock 1000 1000 D Rights 8.50 2001-10-05 4 A 0 3950 0 A 2001-10-05 2005-06-30 Common Stock 3950 3950 D Rights 8.50 2001-10-05 4 A 0 30 0 A 2001-10-05 2005-06-30 Common Stock 30 30 D Upon a transfer of shares to which the rights attach the rights are no longer exercisable. Currently exercisable to the extent of 54,000, with an additional 25,000 becoming exercisable on the next anniversary of the date of grant provided the reporting person remains a member of the Board of Directors. /s/ Jeffrey Levy 2004-12-07 -----END PRIVACY-ENHANCED MESSAGE-----