SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
LINEBERGER JAMES E

(Last) (First) (Middle)
1120 BOSTON POST ROAD

(Street)
DARLEN CT 06820

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
INKSURE TECHNOLOGIES INC [ INKS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
02/24/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 03/26/2004 P 147,059 A $0.68(4) 457,709(1) I See Note(1)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option $0.8 02/24/2004 A 34,000 02/24/2004 02/24/2009 Common Stock 34,000 $0(2) 150,028(3)(5) I See Note(3)(5)
Warrant $1 03/26/2004 P 29,412 03/26/2004 03/26/2009 Common Stock 29,412 $0.68(4) 150,028(3)(5) I See Note(3)(5)
Explanation of Responses:
1. 457,619 shares of Common Stock are owned by The Irrevocable Trust of James E. Lineberger u/a/ 12/17/98.
2. Issued pursuant to the 2003 annual issuance of options to directors.
3. Warrants to purchase 138,107 shares of Common Stock are owned by The Irrevocable Trust of James E. Lineberger u/a/ 12/17/98.
4. The Common Stock was purchased as part of a unit. Each unit consisted of: (i) one share of InkSure's Common Stock, and (ii) a five-year warrant to purchase one share of InlSure's Common Stock at an exercise price of $1.00 per share. The price per unit was $0.68
5. Warrants to purchase 29,412 shares of Common Stock are owned by The Irrevocable Trust of James E. Lineberger u/a/ 12/17/98.
/s/ James E. Lineberger 04/01/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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