0001213900-21-022464.txt : 20210421
0001213900-21-022464.hdr.sgml : 20210421
20210421170500
ACCESSION NUMBER: 0001213900-21-022464
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210419
FILED AS OF DATE: 20210421
DATE AS OF CHANGE: 20210421
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: 21842379
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
2021-04-19
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
5885445
D
Common Stock, $0.0001 par value per share
2021-04-19
4
G
0
8166667
0
D
0
I
See Footnote
Common Stock Purchase Warrant
0.15
2020-06-30
2022-06-30
Common Stock, $0.0001 par value per share
250000
250000
D
Amended and Restated Promissory Notes
0.20
2020-02-14
2022-02-28
Common Stock, $0.0001 par value per share
15000000
15000000
I
See footnote
15% Convertible Note
0.20
2020-02-14
2022-02-28
Common Stock, $0.0001 par value per share
375000
375000
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").
On April 19, 2021, the Trust gifted 8,166,667 shares of common stock to Andrew A. Stern and Jonathan M. Stern, Mr. Stern's adult children, in their capacity as the Trustees of the 2000 Irrevocable Trust for Family of Theodore and Elizabeth S. Stern (the "2000 Trust"). The shares held by the 2000 Trust are subject to a lock up period for a period of one year from the date of the gift. Mr. Stern has no beneficial interest in the 2000 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.
/s/ Theodore Stern
2021-04-21