0000897101-11-001618.txt : 20110922 0000897101-11-001618.hdr.sgml : 20110922 20110922162716 ACCESSION NUMBER: 0000897101-11-001618 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110921 FILED AS OF DATE: 20110922 DATE AS OF CHANGE: 20110922 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tufto Kris B CENTRAL INDEX KEY: 0001484582 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26056 FILM NUMBER: 111103286 MAIL ADDRESS: STREET 1: 2660 CHRISTIAN COURT CITY: CHASKA STATE: MN ZIP: 55318 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 iss114502tufto_4.xml FORM 4 X0304 4 2011-09-21 0 0000943034 IMAGE SENSING SYSTEMS INC ISNS 0001484582 Tufto Kris B 2660 CHRISTIAN COURT CHASKA MN 55318 1 0 0 0 Non-qualified stock option (right to buy) 6.58 2011-09-21 4 A 0 18000 0 A 2021-09-20 Common Stock 18000 18000 D The option becomes exercisable in three equal installments on each of the first, second and third anniversary dates of the date of grant. /s/ Gregory R. L. Smith Attorney-in-Fact for Kris B. Tufto 2011-09-21