0001493152-21-005883.txt : 20210312 0001493152-21-005883.hdr.sgml : 20210312 20210312152415 ACCESSION NUMBER: 0001493152-21-005883 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210310 FILED AS OF DATE: 20210312 DATE AS OF CHANGE: 20210312 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: 001-15465 FILM NUMBER: 21737097 MAIL ADDRESS: STREET 1: 1520 OLD TROLLEY ROAD CITY: SUMMERVILLE STATE: SC ZIP: 29485 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: 200 BROADHOLLOW ROAD STREET 2: SUITE 207 CITY: MELVILLE STATE: NY ZIP: 11747 BUSINESS PHONE: 516-992-1900 MAIL ADDRESS: STREET 1: 200 BROADHOLLOW ROAD STREET 2: SUITE 207 CITY: MELVILLE STATE: NY ZIP: 11747 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 2021-03-10 0 0001040896 Intellicheck, Inc. IDN 0001356205 DAVIS JACK ALAN 200 BROADHOLLOW ROAD, SUITE 207 MELVILLE, NY 11747 1 0 0 0 Option (Right to Buy) 11.50 2021-03-10 4 A 0 6239 0 A 2022-03-10 2026-03-10 Common Stock 6239 0 D Option shall become fully exercisable upon the one-year anniversary of the date of grant. /s/ Bill White, Attorney-In-Fact 2021-03-12