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