0001615774-15-001207.txt : 20150522
0001615774-15-001207.hdr.sgml : 20150522
20150522111224
ACCESSION NUMBER: 0001615774-15-001207
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150520
FILED AS OF DATE: 20150522
DATE AS OF CHANGE: 20150522
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Intellicheck Mobilisa, 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: 191 OTTO STREET
CITY: PORT TOWNSEND
STATE: WA
ZIP: 98368
BUSINESS PHONE: 516-992-1900
MAIL ADDRESS:
STREET 1: 191 OTTO STREET
CITY: PORT TOWNSEND
STATE: WA
ZIP: 98368
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
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: 15885197
MAIL ADDRESS:
STREET 1: INTELLI CHECK INC
STREET 2: 246 CROSSWAYS PARK
CITY: WOODBURY
STATE: NY
ZIP: 11797
4
1
s101190_form4.xml
4
X0306
4
2015-05-20
0
0001040896
Intellicheck Mobilisa, Inc.
IDN
0001197709
EMBRY RUSSELL T
191 OTTO STREET
PORT TOWNSEND
WA
98368
0
1
0
0
Chief Technology Officer
Option (Right to Buy)
1.42
2015-05-20
4
A
0
18970
0
A
2015-05-20
2020-05-20
Common Stock
18970
18970
D
Issued under the Company's 2015 Omnibus Incentive Plan.
/s/ Russell T. Embry
2015-05-22