0000897101-11-000960.txt : 20110527 0000897101-11-000960.hdr.sgml : 20110527 20110527100848 ACCESSION NUMBER: 0000897101-11-000960 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110525 FILED AS OF DATE: 20110527 DATE AS OF CHANGE: 20110527 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MICHALOPOULOS PANOS G CENTRAL INDEX KEY: 0001008477 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26056 FILM NUMBER: 11876358 MAIL ADDRESS: STREET 1: 500 SPRUCE TREE CENTRE STREET 2: 1600 UNIVERSITY AVE WEST CITY: ST PAUL STATE: MN ZIP: 55104-3825 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 image112769michal_4.xml FORM 4 X0303 4 2011-05-25 0 0000943034 IMAGE SENSING SYSTEMS INC ISNS 0001008477 MICHALOPOULOS PANOS G 1600 UNIVERSITY AVENUE W. #500 ST. PAUL MN 55104 1 0 0 0 Non-qualified Stock Option (Right to Buy) 10.15 2011-05-25 4 A 0 4000 0 A 2017-05-25 Common Stock 4000 4000 D The option vests on April 25, 2012. /s/ Gregory R. L. Smith, Attorney-in-Fact for Panos G. Michalopoulos 2011-05-26