4 1 doc1.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ________________________________________________________________________________ 1. Name and Address of Reporting Person* Cohen Paul -------------------------------------------------------------------------------- (Last) (First) (Middle) 15 Majestic Drive -------------------------------------------------------------------------------- (Street) Dix Hills New York 11746 -------------------------------------------------------------------------------- (City) (State) (Zip) Intelli-Check, Inc (IDN) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year November 20, 2002 & November 21, 2002 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) Title if applicable: ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [ ] Form filed by more than one Reporting Person ________________________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) Amount of ship 3. or Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------ Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) ----------------------------------------------------------------------------------------------------------------------------------- Common Stock, $.01 par value 11/20/02* S 2,000 D $4.90 11/20/02* S 1,000 D $5.00 11/20/02* S 3,500 D $4.94 11/20/02* S 500 D $4.97 11/20/02* S 4,000 D $4.94 11/20/02* S 1,000 D $4.91 11/20/02* S 2,000 D $4.95 11/20/02* S 1,000 D $4.90 11/20/02* S 600 D $4.95 11/20/02* S 400 D $4.96 11/20/02* S 200 D $5.06 11/20/02* S 1,800 D $5.06 11/20/02* S 1,000 D $5.10 11/20/02* S 2,000 D $5.10 11/20/02* S 1,000 D $5.12 11/20/02* S 2,000 D $5.10 11/20/02* S 1,000 D $5.20 11/20/02* S 2,000 D $5.22 11/20/02* S 1,300 D $5.21 11/20/02* S 500 D $5.25 11/20/02* S 200 D $5.25 11/21/02* S 800 D $5.10 11/21/02* S 100 D $5.17 11/21/02* S 100 D $5.17 11/21/02 X 50,000 A $3.00 78,500 D 50,000 I **Held By Spouse 2,500 I **Held by ================================================================================================================================= Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. +If the form is filed by more than one reporting person, see Instruction 4(b)(v). *These sales were made by Investec Ernst as Pledgee of Mr. Cohen's shares. **Mr. Cohen disclaims beneficial ownership of these shares.
(Over) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
================================================================================================================================== 10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) ----------------------------------------------------------------------------------------------------------------------------------- Rights S8.50 11/20/02& D 3,000 11/21/02 Options(Right to Buy$2.80 07/15/02 A 45,000 *Current 07/15/07 Common 45,000 Stock Options(Right to Buy)$2.80 07/15/02 A 1,500 Current 07/15/07 Common 1,500 Stock Rights $8.50 12/01 A 400 Current 04/04/03 Common 400 Stock Rights $8.50 10/05/01 A 5,250# Current 04/04/03 Common 5,250# I Stock Rights $8.50 11/13/01 A 6,038 Current 04/04/03 Common 6,038 Stock Rights $8.50 10/05/01 A 4,862 Current 04/04/03 Common 4,862 Stock Options(Right to Buy)$3.00 06/25/98 A 15,000 Current 08/25/03 Common 15,000 Stock Options(Right to Buy)$3.00 08/16/99 A 45,000 Current 08/16/04 Common 45,000 Stock Warrants $3.00 09/99 A 2,500 11/04 Common 2,500 Stock Options(Right to Buy)$12.125 03/13/00 A 3,000 Current 03/13/05 Common 3,000 Stock Options(Right to Buy)$8.75 07/13/00 A 1,500 Current 07/13/00 Common 1,500 Stock Options(Right to Buy)$10.15 07/11/01 1,500 07/11/06 Common 1,500 131,550 D =================================================================================================================================== Explanation of Responses: EXPLANATION OF RESPONSES: # THESE RIGHTS ATTACH TO THE SHARES OWNED BY MR. COHEN'S SPOUSE AND DAUGHTER. MR. COHEN DISCLAIMS BENEFICIAL OWNERSHIP OF THESE RIGHTS AND THE SHARES UNDERLYING THEM. UPON A TRANSFER OF SHARES TO WHICH THE RIGHTS ATTACH THE RIGHTS ARE NO LONGER EXERCISABLE. *CURRENTLY EXERCISABLE TO THE EXTENT OF 15,000, WITH AN ADDITIONAL 15,000 BECOMING EXERCISABLE ON EACH OF THE NEXT TWO ANNIVERSARIES OF THE DATE OF GRANT PROVIDED THE REPORTING PERSON REMAINS A MEMBER OF THE BOARD OF DIRECTORS. **INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACTS CONSTITUTE FEDERAL CRIMINAL VIOLATIONS. /S/ PAUL COHEN November 22,2002 NOVEMBER 22, 2002 SEE 18 U.S.C. 1001 AND 15 U.S.C. 78FF(A). --------------------------------- -------------- ***SIGNATURE OF REPORTING PERSON DATE PAUL COHEN ***THE DISPOSAL OF THESE RIGHTS WAS DUE TO SALES OF SHARES BY INVESTEC ERNST AS PLEDGEE OF MR. COHEN'S SHARES NOTE: FILE THREE COPIES OF THIS FORM, ONE OF WHICH MUST BE MANUALLY SIGNED. IF SPACE PROVIDED IS INSUFFICIENT, SEE INSTRUCTION 6 FOR PROCEDURE. POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB NUMBER.
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