SEC Form 4 · accession 0001615774-18-003156
Ipsidy Inc. · IDTY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Theodore Stern
Director
Period of report
Apr 30, 2018
Accepted (ET)
May 2, 2018 · 10:39 am EDT
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 shareF2 | Apr 30, 2018 | A | 1,500,000 | $0.28 | A | 1,500,000 | I | See Footnote |
| Common Stock, $0.0001 par value per share | holding | — | — | — | 6,506,667 | 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, $0.0001 par value per share | 1,000,000 | 1,000,000 | D |
| Interest SharesF1 | $0.20 | holding | — | — | — | Jan 31, 2017 | — | Common Stock, $0.0001 par value per share | 1,875,000 | 1,875,000 | I |
Explanation of responses
- F11,875,000 shares of common stock that may be issued upon the conversion of interest accrued at $0.20 per share as of December 31, 2017 under that certain Unsecured Promissory Note in the principal amount of $3,000,000 (the "Note") issued to the Theodore Stern Revocable Trust (the "Trust").
- F2On April 30, 2018, in consideration of extending the maturity date of the Note held by the Trust to April 30, 2020 and other consideration, the Company issued the Trust 1,500,000 shares of common stock.