0001493152-21-004616.txt : 20210223
0001493152-21-004616.hdr.sgml : 20210223
20210223170729
ACCESSION NUMBER: 0001493152-21-004616
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210222
FILED AS OF DATE: 20210223
DATE AS OF CHANGE: 20210223
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: 21666664
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
2021-02-22
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
2021-02-22
4
F
0
22279
13.32
D
73562
D
Common Stock, $.001 par value
2021-02-22
4
M
0
14001
1.01
A
87563
D
Option (Right to Buy)
1.01
2021-02-22
4
M
0
22279
0
D
2016-02-24
2021-02-24
Common Stock
22279
0
D
Of the 22,279 options granted, 8,278 were surrendered to Intellicheck as settlement for the cashless exercise and tax withholding resulting in the acquisition of 14,001 shares.
/s/ Russell T. Embry
2021-02-23