0001493152-20-015310.txt : 20200812 0001493152-20-015310.hdr.sgml : 20200812 20200812110911 ACCESSION NUMBER: 0001493152-20-015310 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200810 FILED AS OF DATE: 20200812 DATE AS OF CHANGE: 20200812 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: 001-15465 FILM NUMBER: 201094650 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 ownership.xml X0306 4 2020-08-10 0 0001040896 Intellicheck, Inc. IDN 0001197709 EMBRY RUSSELL T 535 BROAD HOLLOW ROAD, SUITE B51 MELVILLE NY 11747 0 1 0 0 Chief Technology Officer Common Stock, $.001 par value 2020-08-10 4 F 0 92500 8.23 D 19451 D Common Stock, $.001 par value 2020-08-10 4 M 0 54111 1.15 A 73562 D Option (Right to Buy) 1.15 2020-08-10 4 M 0 92500 0 D 2015-08-11 2020-08-11 Common Stock 92500 0 D Of the 92,500 options granted, 38,389 were surrendered to Intellicheck as settlement for the cashless exercise and tax withholding resulting in the acquisition of 54,111 shares. /s/ Russell T. Embry 2020-08-12