0001178913-11-000699.txt : 20110307 0001178913-11-000699.hdr.sgml : 20110307 20110307133510 ACCESSION NUMBER: 0001178913-11-000699 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110302 FILED AS OF DATE: 20110307 DATE AS OF CHANGE: 20110307 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Peleg Gadi CENTRAL INDEX KEY: 0001443071 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24431 FILM NUMBER: 11667806 MAIL ADDRESS: STREET 1: 551 5TH AVENUE, 24TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10176 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INKSURE TECHNOLOGIES INC. CENTRAL INDEX KEY: 0001062128 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS CHEMICAL PRODUCTS [2890] IRS NUMBER: 841417774 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: P.O. BOX 7006 CITY: AUDUBON STATE: PA ZIP: 19407 BUSINESS PHONE: (954) 772-8507 MAIL ADDRESS: STREET 1: P.O. BOX 7006 CITY: AUDUBON STATE: PA ZIP: 19407 FORMER COMPANY: FORMER CONFORMED NAME: INKSURE TECHNOLOGIES INC DATE OF NAME CHANGE: 19980519 4 1 zk1109572.xml X0303 4 2011-03-02 0 0001062128 INKSURE TECHNOLOGIES INC. INKS.OB 0001443071 Peleg Gadi 551 5TH AVENUE, 24TH FLOOR NEW YORK NY 10176 1 1 0 0 Chairman of the Board Common Stock 2011-03-02 4 A 0 277778 0.18 A 4227778 I See Footnote Includes 750,000 shares of common stock underlying options and warrants which are currently exercisable or exercisable within 60 days of March 03, 2011. 3,200,000 shares of Common Stock are held by Peleg Investment Management LLC, which is controlled by Mr. Gadi Peleg. /s/ Gadi Peleg 2011-03-03