SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Kouzelos Michael P

(Last) (First) (Middle)
6050 OAK TREE BLVD.
SUITE 500

(Street)
CLEVELAND OH 44131

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/01/2015
3. Issuer Name and Ticker or Trading Symbol
CBIZ, Inc. [ CBZ ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, Employee Services
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 186,405 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option(1) 05/13/2011 05/13/2016 Common Stock 70,000 $6.75 D
Employee Stock Option(2) 04/04/2012 04/04/2017 Common Stock 70,000 $7.41 D
Employee Stock Option(3) 05/22/2013 05/22/2018 Common Stock 70,000 $5.87 D
Employee Stock Option(4) 05/09/2014 05/09/2019 Common Stock 70,000 $6.52 D
Employee Stock Option(5) 05/14/2015 05/14/2020 Common Stock 70,000 $8.36 D
Explanation of Responses:
1. Annual equity compensation award granted on 5-13-2010, vesting 25% of the original award in each of the four anniversaries following the grant date.
2. Annual equity compensation award granted on 4-4-2011, vesting 25% of the original award in each of the four anniversaries following the grant date.
3. Annual equity compensation award granted on 5-22-2012, vesting 25% of the original award in each of the four anniversaries following the grant date.
4. Annual equity compensation award granted on 5-9-2013, vesting 25% in each of the four anniversaries following the grant date.
5. Annual equity compensation award granted on 5-14-2014, vesting 25% in each of the four anniversaries following the grant date.
Remarks:
Mr. Kouzelos was appointed President, Employee Services on May 1, 2015
Michael W. Gleespen, Attorney-In-Fact for Michael P. Kouzelos 05/05/2015
** Signature of Reporting Person Date
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 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.