0001493152-15-004653.txt : 20151002 0001493152-15-004653.hdr.sgml : 20151002 20151002125434 ACCESSION NUMBER: 0001493152-15-004653 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150930 FILED AS OF DATE: 20151002 DATE AS OF CHANGE: 20151002 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: DAVIS JACK ALAN CENTRAL INDEX KEY: 0001356205 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50296 FILM NUMBER: 151139360 MAIL ADDRESS: STREET 1: 1520 OLD TROLLEY ROAD CITY: SUMMERVILLE STATE: SC ZIP: 29485 4 1 form4.xml X0306 4 2015-09-30 0 0001040896 Intellicheck Mobilisa, Inc. IDN 0001356205 DAVIS JACK ALAN 191 OTTO STREET PORT TOWNSEND WA 98368 1 0 0 0 Restricted Stock Unit 0.90 2015-09-30 4 A 0 4166 0 A 2015-09-30 Common Stock 4166 4166 D Restricted Stock Units shall become earned and vested, and shares of stock shall be issued in settlement of Vested Restricted Stock Units on September 30, 2015. /s/ Bill White, Attorney-In-Fact 2015-10-02