0001213900-21-045475.txt : 20210830
0001213900-21-045475.hdr.sgml : 20210830
20210830080103
ACCESSION NUMBER: 0001213900-21-045475
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210826
FILED AS OF DATE: 20210830
DATE AS OF CHANGE: 20210830
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Broenniman Philip R
CENTRAL INDEX KEY: 0001781770
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40747
FILM NUMBER: 211221027
MAIL ADDRESS:
STREET 1: C/O CSS INDUSTRIES, INC.
STREET 2: 450 PLYMOUTH ROAD, SUITE 300
CITY: PLYMOUTH MEETING
STATE: PA
ZIP: 19462
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ipsidy Inc.
CENTRAL INDEX KEY: 0001534154
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 670 LONG BEACH BLVD.
CITY: LONG BEACH
STATE: NY
ZIP: 11561
BUSINESS PHONE: 516-274-8700
MAIL ADDRESS:
STREET 1: 670 LONG BEACH BLVD.
CITY: LONG BEACH
STATE: NY
ZIP: 11561
FORMER COMPANY:
FORMER CONFORMED NAME: ID Global Solutions Corp
DATE OF NAME CHANGE: 20141014
FORMER COMPANY:
FORMER CONFORMED NAME: IIM Global Corp
DATE OF NAME CHANGE: 20130107
FORMER COMPANY:
FORMER CONFORMED NAME: Silverwood Acquisition Corp
DATE OF NAME CHANGE: 20111102
4
1
ownership.xml
X0306
4
2021-08-26
0
0001534154
Ipsidy Inc.
AUID
0001781770
Broenniman Philip R
C/O IPSIDY INC.
670 LONG BEACH BLVD.
LONG BEACH
NY
11561
1
0
0
0
Common Stock, $.0001 par value
172747
D
Common Stock, $.0001 par value
2021-08-26
4
P
0
35700
7.00
A
340832
I
See footnote
Stock Options
7.20
2021-05-05
2031-05-05
Common Stock, $0.0001 par value per share
588744
588744
D
Warrants
4.50
2020-06-30
2022-06-30
Common Stock, $0.0001 par value per share
30972
30972
I
See Footnotes
Stock Options
2.10
2020-05-22
2025-05-22
Common Stock, $0.0001 par value per share
555556
555556
D
Warrants
4.95
2018-08-15
2023-08-15
Common Stock, $0.0001 par value per share
11667
11667
D
Warrants
2.64
2019-06-24
2024-06-23
Common Stock, $0.0001 par value per share
8750
8750
D
Includes the right to acquire 50,000 shares of common stock at par value subject to the certain vesting criteria granted to Mr. Broenniman on March 6, 2020 pursuant to a Restricted Stock Purchase Agreement.
Mr. Broenniman is the Managing Partner of Varana Capital, LLC ("Varana Capital"), which, in turn, is the investment manager of and has dispositive control over the shares held by Varana Capital Focused, LP ("VCFLP"). By virtue of these relationships, in addition to the shares he holds personally, Mr. Broenniman may be deemed to beneficially own the shares held by Varana Capital Focused, LP.
On May 5, 2021, the Company granted Mr. Broenniman a Non-Statutory Option to acquire 588,744 shares of common stock at an exercise price of $7.20 per share with 5,410 shares vesting upon grant of Non-Statutory Option and 583,333 shares of common stock underlying the stock options vesting subject to various performance conditions.
/s/ Philip R. Broenniman
2021-08-27