0001144204-11-061620.txt : 20111107 0001144204-11-061620.hdr.sgml : 20111107 20111107152916 ACCESSION NUMBER: 0001144204-11-061620 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111104 FILED AS OF DATE: 20111107 DATE AS OF CHANGE: 20111107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Malone Michael CENTRAL INDEX KEY: 0001525225 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50296 FILM NUMBER: 111184451 MAIL ADDRESS: STREET 1: 191 OTTO STREET CITY: PORT TOWNSEND STATE: WA ZIP: 98368 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Intellicheck Mobilisa, 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: 191 OTTO STREET CITY: PORT TOWNSEND STATE: WA ZIP: 98368 BUSINESS PHONE: 516-992-1900 MAIL ADDRESS: STREET 1: 191 OTTO STREET CITY: PORT TOWNSEND STATE: WA ZIP: 98368 FORMER COMPANY: FORMER CONFORMED NAME: Intelli Check Mobilisa, Inc DATE OF NAME CHANGE: 20080319 FORMER COMPANY: FORMER CONFORMED NAME: INTELLI CHECK INC DATE OF NAME CHANGE: 19990917 4 1 v239417_4.xml OWNERSHIP DOCUMENT X0304 4 2011-11-04 0 0001040896 Intellicheck Mobilisa, Inc. IDN 0001525225 Malone Michael 191 OTTO STREET PORT TOWNSEND WA 98368 1 0 0 0 Common Stock, $.001 par value 2011-11-04 4 P 0 2391 1.06 A 2391 D Common Stock, $.001 par value 2011-11-04 4 P 0 1228 1.07 A 3619 D Common Stock, $.001 par value 2011-11-04 4 P 0 700 1.09 A 4319 D Common Stock, $.001 par value 2011-11-04 4 P 0 681 1.10 A 5000 D /s/ Michael D. Malone 2011-11-07