0001144204-13-020144.txt : 20130404
0001144204-13-020144.hdr.sgml : 20130404
20130404124144
ACCESSION NUMBER: 0001144204-13-020144
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130328
FILED AS OF DATE: 20130404
DATE AS OF CHANGE: 20130404
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: EMBRY RUSSELL T
CENTRAL INDEX KEY: 0001197709
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-50296
FILM NUMBER: 13742312
MAIL ADDRESS:
STREET 1: INTELLI CHECK INC
STREET 2: 246 CROSSWAYS PARK
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
v340510_4.xml
OWNERSHIP DOCUMENT
X0306
4
2013-03-28
0
0001040896
Intellicheck Mobilisa, Inc.
IDN
0001197709
EMBRY RUSSELL T
191 OTTO ST.
PORT TOWNSEND
WA
98368
0
1
0
0
Chief Technology Officer
Option (Right to Buy)
0.39
2013-03-28
4
A
0
25000
0
A
2014-03-28
2018-03-28
Common Stock
25000
25000
D
Issued under the Company's 2006 Equity Incentive Plan. Options vest 25% per year on anniversary of grant.
s/ Russell T. Embry
2013-04-04