0001144204-19-048013.txt : 20191010 0001144204-19-048013.hdr.sgml : 20191010 20191010213622 ACCESSION NUMBER: 0001144204-19-048013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191008 FILED AS OF DATE: 20191010 DATE AS OF CHANGE: 20191010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GREEN WILLIAM D CENTRAL INDEX KEY: 0001232906 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37931 FILM NUMBER: 191146954 MAIL ADDRESS: STREET 1: C/O ACCENTURE STREET 2: 161 N CLARK STREET CITY: CHICAGO STATE: IL ZIP: 60601 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GTY Technology Holdings Inc. CENTRAL INDEX KEY: 0001682325 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 000000000 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1180 NORTH TOWN CENTER DRIVE, STREET 2: SUITE 100 CITY: LAS VEGAS STATE: NV ZIP: 89144 BUSINESS PHONE: (702) 945-2700 MAIL ADDRESS: STREET 1: 1180 NORTH TOWN CENTER DRIVE, STREET 2: SUITE 100 CITY: LAS VEGAS STATE: NV ZIP: 89144 4 1 tv530957_4.xml OWNERSHIP DOCUMENT X0306 4 2019-10-08 0 0001682325 GTY Technology Holdings Inc. GTYH 0001232906 GREEN WILLIAM D C/O GTY TECHNOLOGY HOLDINGS INC. 1180 NORTH TOWN CENTER DRIVE, SUITE 100 LAS VEGAS NV 89144 1 0 0 0 Common Stock 2019-10-08 4 J 0 318979 0 A 318979 D Private Placement Warrants 11.50 2019-10-08 4 J 0 2731111 0 A 2019-03-21 2024-02-19 Common Stock 2731111 2731111 D The shares of common stock and private placement warrants acquired by the Reporting Person and reported herein were received in a pro rata distribution by GTY Investors, LLC (the "Sponsor") to its members in connection with a liquidation of the assets of the Sponsor. As a manager of the Sponsor, the Reporting Person previously may have been deemed to be an indirect beneficial owner of the securities previously held directly by the Sponsor. Each private placement warrant is exercisable for one share of common stock of the Issuer at $11.50 per share, subject to adjustment, as described under the heading "Description of Capital Stock-Warrants-Private Placement Warrants" in the Issuer's registration statement on Form S-1 filed on Form S-3, filed with the SEC on February 27, 2019, as amended. /s/ Daniel Nussen, Attorney-in-Fact for William D. Green 2019-10-10