0001493152-15-003644.txt : 20150813 0001493152-15-003644.hdr.sgml : 20150813 20150813180648 ACCESSION NUMBER: 0001493152-15-003644 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150811 FILED AS OF DATE: 20150813 DATE AS OF CHANGE: 20150813 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roof William H CENTRAL INDEX KEY: 0001616820 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50296 FILM NUMBER: 151051934 MAIL ADDRESS: STREET 1: 191 OTTO STREET CITY: PORT TOWNSEND STATE: WA ZIP: 98368 4 1 form4.xml X0306 4 2015-08-11 0 0001040896 Intellicheck Mobilisa, Inc. IDN 0001616820 Roof William H 191 OTTO STREET PORT TOWNSEND WA 98368 0 1 0 0 President and CEO Option (Right to Buy) 1.15 2015-08-11 4 A 0 513750 0 A 2015-08-11 2020-08-11 Common Stock 513750 513750 D Issued under the Company's 2015 Omnibus Incentive Plan. Of the options granted, 25% shall vest immediately and the remaining options shall vest at a rate of 25% per year beginning on first anniversary of date of grant. /s/ Bill White, Attorney-In-Fact 2015-08-13