0001144204-18-006374.txt : 20180207
0001144204-18-006374.hdr.sgml : 20180207
20180207173017
ACCESSION NUMBER: 0001144204-18-006374
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171115
FILED AS OF DATE: 20180207
DATE AS OF CHANGE: 20180207
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KRZEMIEN GREGORY M
CENTRAL INDEX KEY: 0001267757
STATE OF INCORPORATION: PA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35170
FILM NUMBER: 18582072
MAIL ADDRESS:
STREET 1: 1000 CRAWFORD PL
STREET 2: SUITE 400
CITY: MT LAUREL
STATE: NJ
ZIP: 08054
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: JetPay Corp
CENTRAL INDEX KEY: 0001507986
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 900632274
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1175 LANCASTER AVE., SUITE 200
CITY: BERWYN
STATE: PA
ZIP: 19312
BUSINESS PHONE: 6109772482
MAIL ADDRESS:
STREET 1: 1175 LANCASTER AVE., SUITE 200
CITY: BERWYN
STATE: PA
ZIP: 19312
FORMER COMPANY:
FORMER CONFORMED NAME: Universal Business Payment Solutions Acquisition Corp
DATE OF NAME CHANGE: 20101215
4
1
tv485106_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-11-15
0
0001507986
JetPay Corp
JTPY
0001267757
KRZEMIEN GREGORY M
3939 WEST DRIVE
CENTER VALLEY
PA
18034
0
1
0
0
Chief Financial Officer
Stock Option (Right to Buy)
3.00
2017-11-15
4
A
0
100000
0
A
2027-11-15
Common Stock
100000
100000
D
The stock options vest ratably on a monthly basis over the period commencing on November 15, 2017 and ending November 15, 2019.
/s/ Gregory M. Krzemien
2018-02-07