0001683168-23-003875.txt : 20230602 0001683168-23-003875.hdr.sgml : 20230602 20230602165946 ACCESSION NUMBER: 0001683168-23-003875 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230531 FILED AS OF DATE: 20230602 DATE AS OF CHANGE: 20230602 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HENRY DANIEL R CENTRAL INDEX KEY: 0001253706 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 23989875 MAIL ADDRESS: STREET 1: 13160 BIRCH CITY: OVERLAND PARK STATE: KS ZIP: 66211 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Paysign, Inc. CENTRAL INDEX KEY: 0001496443 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 954550154 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2615 ST. ROSE PARKWAY CITY: HENDERSON STATE: NV ZIP: 89052 BUSINESS PHONE: 702-453-2221 MAIL ADDRESS: STREET 1: 2615 ST. ROSE PARKWAY CITY: HENDERSON STATE: NV ZIP: 89052 FORMER COMPANY: FORMER CONFORMED NAME: 3PEA INTERNATIONAL, INC. DATE OF NAME CHANGE: 20100713 4 1 ownership.xml X0407 4 2023-05-31 0 0001496443 Paysign, Inc. PAYS 0001253706 HENRY DANIEL R 2615 ST. ROSE PARKWAY HENDERSON NV 89052 1 0 0 0 0 Common Stock 2023-05-31 2023-05-31 4 M 0 10000 2.40 A 60000 D On March 17, 2023, the reporting person received a grant of 10,000 shares of common stock vesting on May 31, 2023. As of the date of this filing, 10,000 shares of common stock have vested. /s/ Daniel R. Henry 2023-06-02