0000875355-11-000050.txt : 20110527 0000875355-11-000050.hdr.sgml : 20110527 20110527110911 ACCESSION NUMBER: 0000875355-11-000050 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110525 FILED AS OF DATE: 20110527 DATE AS OF CHANGE: 20110527 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simcox Scott CENTRAL INDEX KEY: 0001373861 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13471 FILM NUMBER: 11876656 MAIL ADDRESS: STREET 1: 6470 SYCAMORE COURT NORTH CITY: MAPLE GROVE STATE: MN ZIP: 55369 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSIGNIA SYSTEMS INC/MN CENTRAL INDEX KEY: 0000875355 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-ADVERTISING [7310] 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 2011-05-25 0 0000875355 INSIGNIA SYSTEMS INC/MN ISIG 0001373861 Simcox Scott 8799 BROOKLYN BLVD MINNEAPOLIS MN 55445 0 1 0 0 Sr. VP of Marketing Services Incentive Stock Option (right to buy) 4.22 2011-05-25 4 A 0 20000 4.22 A 2012-05-25 2021-05-25 Common Stock 20000 20000 D Exercisable in annual one-third increments on the first, second, and third anniversaries of the date of this option grant. /s/ Scott Simcox 2011-05-27