0001493152-17-014985.txt : 20171222 0001493152-17-014985.hdr.sgml : 20171222 20171222145017 ACCESSION NUMBER: 0001493152-17-014985 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171222 FILED AS OF DATE: 20171222 DATE AS OF CHANGE: 20171222 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: 171272439 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, 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: 100 JERICHO QUADRANGLE, STREET 2: SUITE 202 CITY: JERICHO STATE: NY ZIP: 11753 BUSINESS PHONE: 516-992-1900 MAIL ADDRESS: STREET 1: 100 JERICHO QUADRANGLE, STREET 2: SUITE 202 CITY: JERICHO STATE: NY ZIP: 11753 FORMER COMPANY: FORMER CONFORMED NAME: Intellicheck Mobilisa, Inc. DATE OF NAME CHANGE: 20100527 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 form4.xml X0306 4 2017-12-22 0 0001040896 Intellicheck, Inc. IDN 0001197709 EMBRY RUSSELL T 100 JERICHO QUADRANGLE, SUITE 202 JERICHO, NY 11753 0 1 0 0 Chief Technology Officer Common Stock, $.001 par value 2017-12-22 4 M 0 2599 A 2599 D Restricted Stock Unit 2017-12-22 4 M 0 2599 0 A Common Stock 2599 0 D Restricted Stock Units convert into common stock on a one-for-one basis. On May 19, 2016, the reporting person was granted 4,363 restricted stock units, which vested January 2, 2017. Of the 4,363 restricted stock units granted, the reporting person surrendered 1,764 shares for income tax withholding purposes. /s/ Russell T. Embry 2017-12-22