0001144204-12-028383.txt : 20120514 0001144204-12-028383.hdr.sgml : 20120514 20120514114710 ACCESSION NUMBER: 0001144204-12-028383 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120511 FILED AS OF DATE: 20120514 DATE AS OF CHANGE: 20120514 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: 12837253 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 v313158_form4.xml OWNERSHIP DOCUMENT X0305 4 2012-05-11 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 2012-05-11 4 P 0 366 1.63 A 62573 D Common Stock, $.001 par value 2012-05-11 4 P 0 30 1.64 A 62603 D Common Stock, $.001 par value 2012-05-11 4 P 0 100 1.68 A 62703 D Common Stock, $.001 par value 2012-05-11 4 P 0 2200 1.6946 A 64903 D Common Stock, $.001 par value 2012-05-11 4 P 0 2700 1.70 A 67603 D /s/ Guy L. Smith 2012-05-14