0000897101-11-000621.txt : 20110407 0000897101-11-000621.hdr.sgml : 20110407 20110407164715 ACCESSION NUMBER: 0000897101-11-000621 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110405 FILED AS OF DATE: 20110407 DATE AS OF CHANGE: 20110407 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Gregory R L CENTRAL INDEX KEY: 0001383835 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26056 FILM NUMBER: 11746640 MAIL ADDRESS: STREET 1: 3721 GLENHURST AVE CITY: ST LOUIS PARK STATE: MN ZIP: 55416 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMAGE SENSING SYSTEMS INC CENTRAL INDEX KEY: 0000943034 STANDARD INDUSTRIAL CLASSIFICATION: MEASURING & CONTROLLING DEVICES, NEC [3829] IRS NUMBER: 411519168 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 SPRUCE TREE CENTRE STREET 2: 1600 UNIVERSITY AVE CITY: ST PAUL STATE: MN ZIP: 55104-3825 BUSINESS PHONE: 6516037700 MAIL ADDRESS: STREET 1: 500 SPRUCE TREE CENTRE STREET 2: 1600 UNIVERSITY AVE W. CITY: ST PAUL STATE: MN ZIP: 55104 4 1 image111859smith_4.xml FORM 4 X0303 4 2011-04-05 0 0000943034 IMAGE SENSING SYSTEMS INC ISNS 0001383835 Smith Gregory R L 3721 GLENHURST AVE ST LOUIS PARK MN 55416 0 1 0 0 CFO Incentive Stock Options 13.50 2011-04-05 4 A 0 5000 0 A 2017-04-05 Common Stock 5000 57500 D Non-incentive Stock Options 13.50 2011-04-05 4 A 0 5000 0 A 2017-04-05 Common Stock 5000 62500 D Exercisable in two equal installments of 2,500 shares on April 5, 2014 and 2015. 46,430 incentive stock options and 11,070 non-incentive stock options. Exercisable in two equal installments of 2,500 shares on April 5, 2012 and 2013. 46,430 incentive stock options and 16,070 non-incentive stock options. /s/ Gregory R. L. Smith 2011-04-07