0001493152-21-031353.txt : 20211214 0001493152-21-031353.hdr.sgml : 20211214 20211214091637 ACCESSION NUMBER: 0001493152-21-031353 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211210 FILED AS OF DATE: 20211214 DATE AS OF CHANGE: 20211214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gafke Garrett CENTRAL INDEX KEY: 0001854399 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15465 FILM NUMBER: 211489809 MAIL ADDRESS: STREET 1: 200 BROADHOLLOW RD. STREET 2: SUITE 207 CITY: MELVILLE STATE: NY ZIP: 11747 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 2021-12-10 0 0001040896 Intellicheck, Inc. IDN 0001854399 Gafke Garrett 200 BROADHOLLOW ROAD, SUITE 207 MELVILLE NY 11747 0 1 0 0 President Common Stock, $.001 par value 2021-12-10 4 P 0 3000 5.6 A 4000 D Common Stock, $.001 par value 2021-12-10 4 P 0 2000 5.56 A 6000 D Common Stock, $.001 par value 2021-12-10 4 P 0 2000 5.58 A 8000 D Common Stock, $.001 par value 2021-12-10 4 P 0 2000 5.62 A 10000 D Common Stock, $.001 par value 2021-12-10 4 P 0 2000 5.62 A 12000 D Common Stock, $.001 par value 2021-12-10 4 P 0 2000 5.63 A 14000 D Common Stock, $.001 par value 2021-12-10 4 P 0 2000 5.65 A 16000 D Common Stock, $.001 par value 2021-12-10 4 P 0 1000 5.6265 A 17000 D Common Stock, $.001 par value 2021-12-10 4 P 0 1000 5.65 A 18000 D Common Stock, $.001 par value 2021-12-10 4 P 0 1000 5.62 A 19000 D Common Stock, $.001 par value 2021-12-13 4 P 0 2000 5.12 A 21000 D /s/ Garrett Gafke 2021-12-14