-----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, TfDWSLwpGQSOkjnTO9b2YOgrfvIbsCgAxlTKMre5DmLGvQhQ3XO8Pm2qpN2Ow5xh ebb1LN2dBjeazJXdJrbVpg== 0000875355-09-000020.txt : 20090522 0000875355-09-000020.hdr.sgml : 20090522 20090522120917 ACCESSION NUMBER: 0000875355-09-000020 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090520 FILED AS OF DATE: 20090522 DATE AS OF CHANGE: 20090522 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Derycz Peter CENTRAL INDEX KEY: 0001351848 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13471 FILM NUMBER: 09847884 MAIL ADDRESS: STREET 1: 207 10TH STREET CITY: SANTA MONICA STATE: CA ZIP: 90402 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSIGNIA SYSTEMS INC/MN CENTRAL INDEX KEY: 0000875355 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS MANUFACTURING INDUSTRIES [3990] IRS NUMBER: 411656308 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8799 BROOKLYN BLVD. CITY: MINNEAPOLIS STATE: MN ZIP: 55445 BUSINESS PHONE: 7633926200 MAIL ADDRESS: STREET 1: 8799 BROOKLYN BLVD. CITY: MINNEAPOLIS STATE: MN ZIP: 55445 4 1 edgardoc.xml PRIMARY DOCUMENT X0303 4 2009-05-20 0 0000875355 INSIGNIA SYSTEMS INC/MN ISIG 0001351848 Derycz Peter 8799 BROOKLYN BLVD MINNEAPOLIS MN 55445 1 0 0 0 Non-Qualified Stock Option (right to buy) 2.8 2009-05-20 4 A 0 5000 2.8 A 2009-05-20 2019-05-20 Common Stock 5000 5000 D /s/ Peter Derycz 2009-05-21 -----END PRIVACY-ENHANCED MESSAGE-----