0001213900-20-004135.txt : 20200218 0001213900-20-004135.hdr.sgml : 20200218 20200218161816 ACCESSION NUMBER: 0001213900-20-004135 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200214 FILED AS OF DATE: 20200218 DATE AS OF CHANGE: 20200218 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STERN THEODORE CENTRAL INDEX KEY: 0000935991 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54545 FILM NUMBER: 20625519 MAIL ADDRESS: STREET 1: EXECUTIVE ASSOCIATES STREET 2: ONE PPG PLACE, SUITE 2970 CITY: PITTSBURGH STATE: PA ZIP: 15222 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Ipsidy Inc. CENTRAL INDEX KEY: 0001534154 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 670 LONG BEACH BLVD. CITY: LONG BEACH STATE: NY ZIP: 11561 BUSINESS PHONE: 516-274-8700 MAIL ADDRESS: STREET 1: 670 LONG BEACH BLVD. CITY: LONG BEACH STATE: NY ZIP: 11561 FORMER COMPANY: FORMER CONFORMED NAME: ID Global Solutions Corp DATE OF NAME CHANGE: 20141014 FORMER COMPANY: FORMER CONFORMED NAME: IIM Global Corp DATE OF NAME CHANGE: 20130107 FORMER COMPANY: FORMER CONFORMED NAME: Silverwood Acquisition Corp DATE OF NAME CHANGE: 20111102 4 1 ownership.xml X0306 4 2020-02-14 0 0001534154 Ipsidy Inc. IDTY 0000935991 STERN THEODORE 220 N. BELLEFIELD AVE., UNIT 1101 PITTSBURGH PA 15213 1 0 0 0 Common Stock, $0.0001 par value per share 4885445 D Common Stock, $0.0001 par value per share 8166667 I See Footnote Amended and Restated Promissory Notes 0.20 2020-02-14 4 P 0 15000000 0.2 A 2020-02-14 2022-02-28 Common Stock, $0.0001 par value per share 15000000 15000000 I See footnote 15% Convertible Note 0.2 2020-02-14 4 P 0 375000 0.2 A 2020-02-14 2022-02-28 Common Stock, $0.0001 par value per share 375000 375000 D Common Stock Purchase Warrant 0.10 2016-04-19 2021-04-19 Common Stock, $0.0001 par value per share 1000000 1000000 D Interest Shares 0.20 2017-01-31 Common Stock, $0.0001 par value per share 3310000 3310000 I See Footnote Shares of common stock are held by the Theodore Stern Revocable Trust (the "Trust"). Represents 3,310,000 shares of common stock that may be issued upon the conversion of interest accrued at $0.20 per share under issued under that certain Unsecured Promissory Note in the principal amount as of the date hereof $2,000,000 issued to the Trust. In connection with the Company's private offering, Mr. Stern acquired a 15% Convertible Note. The 15% Convertible Note is convertible into an amount equal to 150% of the principal amount due under the 15% Convertible Note divided by the conversion price of $0.20 per share. The Company issued the Stern Trust an Amended and Restated Promissory Note. The Amended and Restated Promissory Note is convertible into an amount equal to 150% of the principal amount due under the Amended and Restated Promissory Note divided by the conversion price of $0.20 per share. /s/ Theodore Stern 2020-02-18