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