Specialized Disclosure Report (sd)
May 31 2017 - 4:04PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington,
D.C. 20549
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FORM SD
Specialized Disclosure Report
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Image Sensing Systems, Inc.
(Exact
name of registrant as specified in its charter)
Minnesota
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0-26056
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41-1519168
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(State or other jurisdiction of
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(Commission
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(I.R.S. Employer
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incorporation or organization)
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File Number)
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Identification No.)
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500 Spruce Tree Centre, 1600 University Avenue West,
St. Paul, MN 55104
(Address of
principal executive offices) (Zip
Code)
Richard A. Ehrich, telephone: 651-603-7700
(Name
and telephone number, including area code, of the person to contact in
connection with this report.)
Check the
appropriate box below to indicate the rule pursuant to which this form is being
filed, and provide the period to which the information in this form applies:
[X ] Rule 13p-1 under the
Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from
January 1 to December 31, 2016.
SECTION 1 - Conflict Minerals Disclosure
ITEM 1.01 Conflict
Minerals Disclosure and Report
Image Sensing Systems, Inc. (the
“Company”) has filed a Conflict Minerals Report with the Securities and
Exchange Commission as Exhibit 1.01 hereto, which is publicly available at www.imagesensing.com.
ITEM 1.02 Exhibit
The Company has filed the Conflict
Minerals Report required by Item 1.01 as Exhibit 1.01 to this Form SD.
SECTION 2 - Exhibits
ITEM 2.01 Exhibits
The following exhibit is filed as
part of this report:
Exhibit 1.01 - Conflict Minerals
Report as required by Items 1.01 and 1.02 of this Form.
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the duly authorized undersigned.
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Image Sensing Systems, Inc..
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By:
/s/ Richard A. Ehrich
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Richard A. Ehrich,
Chief Financial Officer (Principal Financial Officer and Principal Accounting Officer)
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Date: May 31, 2017
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