0001628280-23-006963.txt : 20230308
0001628280-23-006963.hdr.sgml : 20230308
20230308153916
ACCESSION NUMBER: 0001628280-23-006963
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230303
FILED AS OF DATE: 20230308
DATE AS OF CHANGE: 20230308
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: 23715996
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: 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
wf-form4_167830794374394.xml
FORM 4
X0306
4
2023-03-03
0
0001040896
Intellicheck, Inc.
IDN
0001197709
EMBRY RUSSELL T
200 BROADHOLLOW ROAD, SUITE 207
MELVILLE
NY
11747
0
1
0
0
Chief Technology Officer
Stock Option (Right to Buy)
2.7
2023-03-03
4
A
0
22500
2.70
A
2024-03-03
2028-03-03
Common Stock
22500.0
22500
D
Of these options, 50% (11,250) have no premium (i.e. exercise price equals stock price at grant); 25% (5,625) of the options have a 20% premium (i.e. exercise price equals stock price at grant plus 20%); and 25% (5,625) of the options have a 40% premium (i.e. exercise price equals stock price at grant plus 40%).
One-third of this Option shall vest upon the first anniversary of the date of grant and the remaining two-thirds of this Option shall vest quarterly over the following two years.
/s/ Russell T. Embry
2023-03-08