INTELLICHECK, INC. |
(Name of Issuer) |
COMMON STOCK, $0.001 PAR VALUE |
(Title of Class of Securities) |
45817G201 |
(CUSIP Number) |
DECEMBER 31, 2018 |
(Date of Event Which Requires Filing of This Statement)
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☐ |
Rule 13d-1(b)
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Rule 13d-1(c)
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Rule 13d-1(d)
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CUSIP No. 45817G201
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Page 2 of 5 Pages
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1
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NAME OF REPORTING PERSONS
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Rawleigh Hazen Ralls, IV
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
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(a)☐
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(b)☒
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
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United States of America
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NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
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5
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SOLE VOTING POWER
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699,914
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6
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SHARED VOTING POWER
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974,914
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7
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SOLE DISPOSITIVE POWER
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699,914
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8
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SHARED DISPOSITIVE POWER
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974,914
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
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974,914
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10
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CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
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☐
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
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6.2% (1) |
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12
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
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IN |
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CUSIP No. 45817G201
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Page 3 of 5 Pages
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Item 1(a) |
Name of Issuer
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Item 1(b) |
Address of Issuer’s Principal Executive Offices
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Item 2(a) |
Name of Person Filing
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Item 2(b) |
Address of Principal Business Office or, if none, Residence
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Item 2(c) |
Citizenship
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Item 2(d) |
Title of Class of Securities
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Item 2(e) |
CUSIP Number
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Item 4 |
Ownership
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Sole
Voting
Power
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Shared
Voting
Power
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Sole
Dispositive
Power
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Shared
Dispositive
Power
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Beneficial
Ownership
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Percentage
of Class (1)
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Rawleigh Hazen Ralls, IV
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699,914
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974,914
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(2)
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699,914
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974,914
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(2)
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974,914
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(2)
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6.2
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%
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(1) |
This percentage is calculated based upon 15,638,765 shares of the Issuer’s common stock outstanding as of November 14, 2018 as reported in the Issuer’s Quarterly Report
on Form 10-Q for the period ended September 30, 2018 (Commission File No. 000-50296) filed with the Securities and Exchange Commission on November 14, 2018.
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(2) |
Includes 335,000 shares held by the Rawleigh Ralls Individual Retirement Account, 150,000 shares held directly by Kate Ralls, his spouse, and 125,000 shares held by the
Kate Ralls Individual Reitrement Account.
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Item 5 |
Ownership of Five Percent or Less of a Class
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Item 6 |
Ownership of More than Five Percent of Another Person
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Item 7 |
Identification and Classification of the Subsidiary which Acquired the Security Being Reported on by the
Parent Holding Company
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CUSIP No. 45817G201
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Page 4 of 5 Pages
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Item 8 |
Identification and Classification of Members of the Group
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Item 9 |
Notice of Dissolution of Group
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Item 10 |
Certification
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/s/ Rawleigh Hazen Ralls, IV
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RAWLEIGH HAZEN RALLS, IV
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