SEC Form 4 · accession 0001615774-17-007480
Ipsidy Inc. · IDTY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Theodore Stern
Director
Period of report
Dec 19, 2017
Accepted (ET)
Dec 20, 2017 · 4:35 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001534154
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, $0.0001 par value per share | Dec 19, 2017 | P | 2,000,000 | $0.13 | A | 15,495,890 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock Purchase Warrant | $0.10 | holding | — | — | — | Apr 19, 2016 | Apr 19, 2021 | Common Stock | 1,000,000 | 1,000,000 | D |
| Interest SharesF1 | $0.20 | holding | — | — | — | Jan 31, 2017 | — | Common Stock | 1,400,000 | 1,400,000 | I |
Explanation of responses
- F11,400,000 shares of common stock that may be issued upon the conversion of interest accrued at $0.20 per share as of September 30, 2017 under that certain Unsecured Promissory Note due January 31, 2019 in the principal amount of $3,000,000 issued to the Theodore Stern Revocable Trust.