0001213900-22-014524.txt : 20220323
0001213900-22-014524.hdr.sgml : 20220323
20220323170025
ACCESSION NUMBER: 0001213900-22-014524
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220321
FILED AS OF DATE: 20220323
DATE AS OF CHANGE: 20220323
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Broenniman Philip R
CENTRAL INDEX KEY: 0001781770
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40747
FILM NUMBER: 22763774
MAIL ADDRESS:
STREET 1: C/O CSS INDUSTRIES, INC.
STREET 2: 450 PLYMOUTH ROAD, SUITE 300
CITY: PLYMOUTH MEETING
STATE: PA
ZIP: 19462
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
2022-03-21
0
0001534154
Ipsidy Inc.
AUID
0001781770
Broenniman Philip R
C/O IPSIDY INC.
670 LONG BEACH BLVD.
LONG BEACH
NY
11561
1
0
0
0
Common Stock, $.0001 par value
2022-03-21
4
A
0
311
3.22
A
173058
D
Common Stock, $.0001 par value
2022-03-21
4
A
0
3106
3.22
A
343938
I
See footnote
Senior Secured Convertible Note
3.70
2022-03-21
4
A
0
270270
1000000
A
2022-03-21
2025-03-21
Common Stock, $0.0001 par value per share
270270
270270
I
See Footnotes
Senior Secured Convertible Note
3.70
2022-03-21
4
A
0
27027
100000
A
2022-03-21
2025-03-21
Common Stock, $0.0001 par value per share
27027
27027
D
Stock Options
15.16
2021-12-29
2031-12-29
Common Stock, $0.0001 par value per share
10238
10238
D
Stock Options
7.20
2021-05-05
2031-05-05
Common Stock, $0.0001 par value per share
388744
388744
D
Warrants
4.50
2020-06-30
2022-06-30
Common Stock, $0.0001 par value per share
30972
30972
I
See Footnotes
Stock Options
2.10
2020-05-22
2025-05-22
Common Stock, $0.0001 par value per share
555556
555556
D
Warrants
4.95
2018-08-15
2023-08-15
Common Stock, $0.0001 par value per share
11667
11667
D
Warrants
2.64
2019-06-24
2024-06-23
Common Stock, $0.0001 par value per share
8750
8750
D
Mr. Broenniman is the Managing Partner of Varana Capital, LLC ("Varana Capital"), which, in turn, is the investment manager of and has dispositive control over the shares held by Varana Capital Focused, LP ("VCFLP"). By virtue of these relationships, in addition to the shares he holds personally, Mr. Broenniman may be deemed to beneficially own the shares held by Varana Capital Focused, LP.
The shares vest monthly in equal amounts over a one-year period.
383,334 of the shares vest upon meeting performance criteria.
Upon acquiring the Senior Secured Convertible Note, the reporting person was issued an origination fee in shares of common stock equal to 1.0% of the original principal amount of the reporting person's Senior Secured Convertible Notes with the value of each such share being the arithmetic average of the volume weighted average price of the Common Stock for each of the ten trading days immediately preceding the effective date.
/s/ Philip R. Broenniman
2022-03-23