SEC Form 4 · accession 0001615774-18-008297
Ipsidy Inc. · IDTY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Theodore Stern
Director
Period of report
Aug 15, 2018
Accepted (ET)
Aug 17, 2018 · 4:13 pm 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 | Aug 15, 2018 | A | 6,666,667 | $0.15 | A | 8,166,667 | 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 | 1,577,500 | 1,577,500 | I |
Explanation of responses
- F11,577,500 shares of common stock that may be issued upon the conversion of interest accrued at $0.20 per share as of August 9, 2018 under that certain Unsecured Promissory Note in the principal amount as of the date hereof $2,000,000 (the "Note") issued to the Theodore Stern Revocable Trust (the "Trust").
- F2On August 15, 2018, the Trust acquired 6,666,667 shares of common stock.