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