SEC Form 4 · accession 0001615774-18-013941
Ipsidy Inc. · IDTY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Theodore Stern
Director
Period of report
Dec 3, 2018
Accepted (ET)
Dec 6, 2018 · 5:05 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 shareF1 | Dec 4, 2018 | G | 2,200,000 | $0.10 | D | 4,885,445 | D | |
| Common Stock, $0.0001 par value per shareF2 | Dec 3, 2018 | A | 578,778 | $0.0001 | A | 7,085,445 | D | |
| Common Stock, $0.0001 par value per shareF3 | holding | — | — | — | 8,166,667 | I | See Footnote |
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 SharesF4 | $0.20 | holding | — | — | — | Jan 31, 2017 | — | Common Stock, $0.0001 par value per share | 1,733,335 | 1,733,335 | I |
Explanation of responses
- F1On December 4, 2018, Theodore Stern gifted 2,200,000 shares of common stock to the Jewish Federation of Greater Pittsburgh.
- F2On December 3, 2018, Mr. Stern and Ipsidy Inc. entered into a Restricted Stock Agreement pursuant to which Mr. Stern acquired 578,778 shares of common stock in connection with his service as a director.
- F3Shares of common stock are held by the Theodore Stern Revocable Trust (the "Trust").
- F41,733,335 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 issued to the Trust.