0001213900-22-037222.txt : 20220705 0001213900-22-037222.hdr.sgml : 20220705 20220705162555 ACCESSION NUMBER: 0001213900-22-037222 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220630 FILED AS OF DATE: 20220705 DATE AS OF CHANGE: 20220705 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gorriz Michael A CENTRAL INDEX KEY: 0001868845 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40747 FILM NUMBER: 221065262 MAIL ADDRESS: STREET 1: 18 KING ALBERT PARK CITY: SINGAPORE STATE: U0 ZIP: 596137 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 2022-06-30 0 0001534154 Ipsidy Inc. AUID 0001868845 Gorriz Michael A C/O IPSIDY INC. 670 LONG BEACH BLVD. LONG BEACH NY 11561 1 0 0 0 Common Stock, $.0001 par value 2022-06-30 4 M 0 915 2.99 A 1226 D Senior Secured Convertible Note 3.70 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 7.80 2021-06-09 2031-06-09 Common Stock, $0.0001 par value per share 62500 62500 D The shares vest annually in equal amounts over a three-year period. The shares vest monthly in equal amounts over a one-year period. The reporting person received 915 shares of common stock at a per share price of $2.99 as payment of interest for the quarter ended June 30, 2022 associated with the Senior Secured Convertible Note dated March 21, 2022. /s/ Michael A. Gorriz 2022-07-05