U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
[_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Cohen Paul
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(Last) (First) (Middle)
15 Majestic Drive
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(Street)
Dix Hills New York 11746
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(City) (State) (Zip)
Intelli-Check, Inc (IDN)
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2. Issuer Name and Ticker or Trading Symbol
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
December 3, 2002
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [ ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
Title if applicable:
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form filed by one Reporting Person
[ ] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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6.
4. 5. Owner-
Securities Acquired (A) Amount of ship
3. or Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------ Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock, $.01 par value 12/03/02 S 1,000 D $8.25
12/03/02 S 1,000 D $8.25 I **Held By
Spouse
77,500 D
49,000 I **Held By
Spouse
2,500 I **Held by
Daughter
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
+If the form is filed by more than one reporting person, see Instruction 4(b)(v).
*These sales were made by Investec Ernst as Pledgee of Mr. Cohen's shares.
**Mr. Cohen disclaims beneficial ownership of these shares.
(Over)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Rights S8.50 12/03/02 D 200
Options(Right to Buy$2.80 07/15/02 A 45,000 *Current 07/15/07 Common 45,000
Stock
Options(Right to Buy)$2.80 07/15/02 A 1,500 Current 07/15/07 Common 1,500
Stock
Rights $8.50 12/01 A 400 Current 04/04/03 Common 400
Stock
Rights $8.50 10/05/01 A 5,150# Current 04/04/03 Common 5,150# I
Stock
Rights $8.50 11/13/01 A 6,038 Current 04/04/03 Common 6,038
Stock
Rights $8.50 10/05/01 A 4,762 Current 04/04/03 Common 4,762
Stock
Options(Right to Buy)$3.00 06/25/98 A 15,000 Current 08/25/03 Common 15,000
Stock
Options(Right to Buy)$3.00 08/16/99 A 45,000 Current 08/16/04 Common 45,000
Stock
Warrants $3.00 09/99 A 2,500 11/04 Common 2,500
Stock
Options(Right to Buy)$12.125 03/13/00 A 3,000 Current 03/13/05 Common 3,000
Stock
Options(Right to Buy)$8.75 07/13/00 A 1,500 Current 07/13/05 Common 1,500
Stock
Options(Right to Buy)$10.15 07/11/01 1,500 07/11/06 Common 1,500 131,350 D
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Explanation of Responses:
EXPLANATION OF RESPONSES:
# THESE RIGHTS ATTACH TO THE SHARES OWNED BY MR. COHEN'S SPOUSE AND DAUGHTER.
MR. COHEN DISCLAIMS BENEFICIAL OWNERSHIP OF THESE RIGHTS AND THE SHARES
UNDERLYING THEM.
UPON A TRANSFER OF SHARES TO WHICH THE RIGHTS ATTACH THE RIGHTS ARE NO LONGER
EXERCISABLE.
*CURRENTLY EXERCISABLE TO THE EXTENT OF 15,000, WITH AN ADDITIONAL 15,000
BECOMING EXERCISABLE ON EACH OF THE NEXT
TWO ANNIVERSARIES OF THE DATE OF GRANT PROVIDED THE REPORTING PERSON REMAINS A
MEMBER OF THE BOARD OF DIRECTORS.
**INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACTS CONSTITUTE FEDERAL CRIMINAL
VIOLATIONS. /S/ PAUL COHEN December 5,2002
SEE 18 U.S.C. 1001 AND 15 U.S.C. 78FF(A). --------------------------------- --------------
***SIGNATURE OF REPORTING PERSON DATE
PAUL COHEN
***THE DISPOSAL OF THESE RIGHTS WAS DUE TO SALES OF SHARES BY INVESTEC ERNST AS
PLEDGEE OF MR. COHEN'S SHARES
NOTE: FILE THREE COPIES OF THIS FORM, ONE OF WHICH MUST BE MANUALLY SIGNED.
IF SPACE PROVIDED IS INSUFFICIENT, SEE INSTRUCTION 6 FOR PROCEDURE.
POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED
IN THIS FORM ARE NOT
REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB NUMBER.
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