0000897101-12-000831.txt : 20120522
0000897101-12-000831.hdr.sgml : 20120522
20120522170236
ACCESSION NUMBER: 0000897101-12-000831
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120518
FILED AS OF DATE: 20120522
DATE AS OF CHANGE: 20120522
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: 12862218
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
image122243michal_4.xml
OWNERSHIP DOCUMENT
X0305
4
2012-05-18
0
0000943034
IMAGE SENSING SYSTEMS INC
ISNS
0001008477
MICHALOPOULOS PANOS G
500 SPRUCE TREE CENTRE
1600 UNIVERSITY AVENUE WEST
ST. PAUL
MN
55104-3825
1
0
0
0
Common Stock
2012-05-18
4
M
0
15000
3.1
A
319298
I
By Transatlantic Emporium & Tech Exchange LLC
Non-qualified Stock Option (Right to Buy)
3.1
2012-05-18
4
M
0
15000
0
D
2002-09-20
2012-09-20
Common Stock
15000
11000
I
By Transatlantic Emporium & Tech Exchange LLC
Non-qualified Stock Option (Right to Buy)
6.12
2012-05-18
4
A
0
4000
0
A
2016-05-18
Common Stock
4000
4000
D
All of the equity interests of Transatlantic Emporium & Tech Exchange LLC are owned by the reporting person.
The option, representing the right to purchase a total of 36,000 shares, became exercisable as to 24,000 shares on December 31, 2002 and 12,000 shares on December 31, 2003.
The option vests on April 18, 2013.
/s/ Gregory R. L. Smith, Attorney-in-Fact for Panos G. Michalopoulos
2012-05-22