0001213900-20-004135.txt : 20200218
0001213900-20-004135.hdr.sgml : 20200218
20200218161816
ACCESSION NUMBER: 0001213900-20-004135
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200214
FILED AS OF DATE: 20200218
DATE AS OF CHANGE: 20200218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: STERN THEODORE
CENTRAL INDEX KEY: 0000935991
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54545
FILM NUMBER: 20625519
MAIL ADDRESS:
STREET 1: EXECUTIVE ASSOCIATES
STREET 2: ONE PPG PLACE, SUITE 2970
CITY: PITTSBURGH
STATE: PA
ZIP: 15222
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ipsidy Inc.
CENTRAL INDEX KEY: 0001534154
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 670 LONG BEACH BLVD.
CITY: LONG BEACH
STATE: NY
ZIP: 11561
BUSINESS PHONE: 516-274-8700
MAIL ADDRESS:
STREET 1: 670 LONG BEACH BLVD.
CITY: LONG BEACH
STATE: NY
ZIP: 11561
FORMER COMPANY:
FORMER CONFORMED NAME: ID Global Solutions Corp
DATE OF NAME CHANGE: 20141014
FORMER COMPANY:
FORMER CONFORMED NAME: IIM Global Corp
DATE OF NAME CHANGE: 20130107
FORMER COMPANY:
FORMER CONFORMED NAME: Silverwood Acquisition Corp
DATE OF NAME CHANGE: 20111102
4
1
ownership.xml
X0306
4
2020-02-14
0
0001534154
Ipsidy Inc.
IDTY
0000935991
STERN THEODORE
220 N. BELLEFIELD AVE.,
UNIT 1101
PITTSBURGH
PA
15213
1
0
0
0
Common Stock, $0.0001 par value per share
4885445
D
Common Stock, $0.0001 par value per share
8166667
I
See Footnote
Amended and Restated Promissory Notes
0.20
2020-02-14
4
P
0
15000000
0.2
A
2020-02-14
2022-02-28
Common Stock, $0.0001 par value per share
15000000
15000000
I
See footnote
15% Convertible Note
0.2
2020-02-14
4
P
0
375000
0.2
A
2020-02-14
2022-02-28
Common Stock, $0.0001 par value per share
375000
375000
D
Common Stock Purchase Warrant
0.10
2016-04-19
2021-04-19
Common Stock, $0.0001 par value per share
1000000
1000000
D
Interest Shares
0.20
2017-01-31
Common Stock, $0.0001 par value per share
3310000
3310000
I
See Footnote
Shares of common stock are held by the Theodore Stern Revocable Trust (the "Trust").
Represents 3,310,000 shares of common stock that may be issued upon the conversion of interest accrued at $0.20 per share under issued under that certain Unsecured Promissory Note in the principal amount as of the date hereof $2,000,000 issued to the Trust.
In connection with the Company's private offering, Mr. Stern acquired a 15% Convertible Note. The 15% Convertible Note is convertible into an amount equal to 150% of the principal amount due under the 15% Convertible Note divided by the conversion price of $0.20 per share.
The Company issued the Stern Trust an Amended and Restated Promissory Note. The Amended and Restated Promissory Note is convertible into an amount equal to 150% of the principal amount due under the Amended and Restated Promissory Note divided by the conversion price of $0.20 per share.
/s/ Theodore Stern
2020-02-18