-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Ad/Xj8R/7sqBfK9FWbcWXJH0vJr+bUpPNyYZsdu6ZVCFLQIMukOp9d8qwIa+mueN 2Gqjaoh3Nxw+NgbUC7vXpg== 0001144204-10-051287.txt : 20100928 0001144204-10-051287.hdr.sgml : 20100928 20100928170206 ACCESSION NUMBER: 0001144204-10-051287 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100920 FILED AS OF DATE: 20100928 DATE AS OF CHANGE: 20100928 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBSON PERRY CENTRAL INDEX KEY: 0001502065 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13111 FILM NUMBER: 101094330 MAIL ADDRESS: STREET 1: C/O AXION INTERNATIONAL HOLDINGS INC STREET 2: 180 SOUTH STREET, STE 104 CITY: NEW PROVIDENCE STATE: NJ ZIP: 07974 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AXION INTERNATIONAL HOLDINGS, INC. CENTRAL INDEX KEY: 0000753048 STANDARD INDUSTRIAL CLASSIFICATION: PLASTICS FOAM PRODUCTS [3086] IRS NUMBER: 840846389 STATE OF INCORPORATION: CO FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 665 MARTINSVILLE ROAD, SUITE 219 STREET 2: . CITY: BASKING RIDGE STATE: NJ ZIP: 07920-4700 BUSINESS PHONE: 908-542-0888 MAIL ADDRESS: STREET 1: 665 MARTINSVILLE ROAD, SUITE 219 STREET 2: . CITY: BASKING RIDGE STATE: NJ ZIP: 07920-4700 FORMER COMPANY: FORMER CONFORMED NAME: ANALYTICAL SURVEYS INC DATE OF NAME CHANGE: 19920703 3 1 v197710_ex.xml X0203 3 2010-09-20 0 0000753048 AXION INTERNATIONAL HOLDINGS, INC. AXIH 0001502065 JACOBSON PERRY C/O AXION INTERNATIONAL HOLDINGS INC 180 SOUTH STREET, STE 104 NEW PROVIDENCE NJ 07974 1 0 0 0 Common Stock 13000 D Common Stock 175575 I See Footnote Held by Commonwealth Investors LLC, a limited liability company of which Mr. Jacobson is a member. /s/ Perry Jacobson 2010-09-28 -----END PRIVACY-ENHANCED MESSAGE-----