0001437749-21-028573.txt : 20211214 0001437749-21-028573.hdr.sgml : 20211214 20211214172030 ACCESSION NUMBER: 0001437749-21-028573 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211210 FILED AS OF DATE: 20211214 DATE AS OF CHANGE: 20211214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pickle William Henry CENTRAL INDEX KEY: 0001630303 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41092 FILM NUMBER: 211491975 MAIL ADDRESS: STREET 1: C/O INFORMATION ANALYSIS INCORPORATED STREET 2: 11240 WAPLES MILL RD, STE 201 CITY: FAIRFAX STATE: VA ZIP: 22030 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INFORMATION ANALYSIS INC CENTRAL INDEX KEY: 0000803578 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 541167364 STATE OF INCORPORATION: VA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 12015 LEE JACKSON MEMORIAL HWY STREET 2: SUITE 210 CITY: FAIRFAX STATE: VA ZIP: 22033 BUSINESS PHONE: 7033833000 MAIL ADDRESS: STREET 1: 12015 LEE JACKSON MEMORIAL HWY STREET 2: SUITE 210 CITY: FAIRFAX STATE: VA ZIP: 22033 4 1 rdgdoc.xml FORM4_PICKLE_211210 X0306 4 2021-12-10 0000803578 INFORMATION ANALYSIS INC IAIC 0001630303 Pickle William Henry C/O INFORMATION ANALYSIS INCORPORATED 12015 LEE JACKSON MEMORIAL HWY STE 210 FAIRFAX VA 22033 1 Common Stock 2021-12-10 4 A 0 16448 3.04 A 131448 I Shares owned by William and Jean Pickle Trust under shared voting and dispositive power. Warrants (right-to-buy) 4.50 2021-12-10 4 A 0 3290 3.72 A 2023-01-01 2026-12-31 Common Stock 3290 108290 I Warrants for a total of 68,290 shares are owned by William and Jean Pickle Trust under shared voting Mr. Pickle purchased $50,000 of Units in a private placement transaction at $3.04/ Unit, which consisted of 16,448 shares of common stock and Warrants to purchase additional 3,290 shares of common stock. Unit price was based on the Volume Weighted Average Price per share for the five trading days ended December 2, 2021. Warrants to acquire 3,290 shares of common stock reported herein are not exercisable until January 1, 2023. /s/ Matthew T. Sands 2021-12-14