0001144204-12-061442.txt : 20121113 0001144204-12-061442.hdr.sgml : 20121112 20121113134849 ACCESSION NUMBER: 0001144204-12-061442 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121109 FILED AS OF DATE: 20121113 DATE AS OF CHANGE: 20121113 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: 121197822 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 v328318_form4.xml OWNERSHIP DOCUMENT X0306 4 2012-11-09 0 0001040896 Intellicheck Mobilisa, Inc. IDN 0001326916 Smith Guy L 191 OTTO STREET PORT TOWNSEND WA 98638 1 0 0 0 Common Stock, $.001 par value 2012-11-09 4 P 0 5000 1.0382 A 74103 D Common Stock, $.001 par value 2012-11-09 4 P 0 5000 0.98 A 79103 D /s/ Bill White, Attorney-In-Fact 2012-11-13