0000943034-17-000001.txt : 20170314 0000943034-17-000001.hdr.sgml : 20170314 20170314162137 ACCESSION NUMBER: 0000943034-17-000001 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161227 FILED AS OF DATE: 20170314 DATE AS OF CHANGE: 20170314 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stelzig Chad CENTRAL INDEX KEY: 0001678337 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35959 FILM NUMBER: 17688300 MAIL ADDRESS: STREET 1: 500 SPRUCE TREE CENTRE STREET 2: 1600 UNIVERSITY AVE W. CITY: ST. PAUL STATE: MN ZIP: 55104 4/A 1 primary_doc.xml PRIMARY DOCUMENT X0306 4/A 2016-12-27 2016-12-27 0 0000943034 IMAGE SENSING SYSTEMS INC isns 0001678337 Stelzig Chad 500 SPRUCE TREE CENTRE 1600 UNIVERSITY AVE W. ST. PAUL MN 55104 0 1 0 0 Interim President, Interim CEO Common Stock 2016-12-27 4 F 0 4442 3.7 A 5558 D These shares were used to pay the reporting person's tax obligation, and their disposition in this manner is not subject to the trading prohibitions of the issuer's Procedures and Guidelines Governing Insider Trading and Tipping. Amounts have been amended to reflect number of shares beneficially owned following reported transaction, not including the derivative securities he holds, which were inadvertently included in Table 1 of the original Form 4. /s/ Richard A. Ehrich, Attorney-in-fact for Chad Stelzig 2017-03-14