0001144204-11-071071.txt : 20111221
0001144204-11-071071.hdr.sgml : 20111221
20111221174254
ACCESSION NUMBER: 0001144204-11-071071
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111221
FILED AS OF DATE: 20111221
DATE AS OF CHANGE: 20111221
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Smith Guy L
CENTRAL INDEX KEY: 0001326916
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-50296
FILM NUMBER: 111275323
MAIL ADDRESS:
STREET 1: 246 CROSSWAYS PARK WEST
CITY: WOODBURY
STATE: NY
ZIP: 11797
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
v243745_4.xml
OWNERSHIP DOCUMENT
X0304
4
2011-12-21
0
0001040896
Intellicheck Mobilisa, Inc.
IDN
0001326916
Smith Guy L
191 OTTO STREET
PORT TOWNSEND
WA
98368
1
0
0
0
Common Stock, $.001 par value
2011-12-21
4
P
0
1000
0.8588
A
59707
D
Common Stock, $.001 par value
2011-12-21
4
P
0
1000
0.8748
A
60707
D
Common Stock, $.001 par value
2011-12-21
4
P
0
1500
0.86
A
62207
D
/s/ Peter J. Mundy, Attorney-In-Fact
2011-12-21