0001104659-17-059301.txt : 20170927
0001104659-17-059301.hdr.sgml : 20170927
20170927214303
ACCESSION NUMBER: 0001104659-17-059301
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170925
FILED AS OF DATE: 20170927
DATE AS OF CHANGE: 20170927
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Scheirman Scott
CENTRAL INDEX KEY: 0001374969
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37584
FILM NUMBER: 171105440
MAIL ADDRESS:
STREET 1: THE WESTERN UNION COMPANY
STREET 2: 12500 EAST BELFORD AVENUE
CITY: ENGLEWOOD
STATE: CO
ZIP: 80112
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CPI Card Group Inc.
CENTRAL INDEX KEY: 0001641614
STANDARD INDUSTRIAL CLASSIFICATION: SHORT-TERM BUSINESS CREDIT INSTITUTIONS [6153]
IRS NUMBER: 260344657
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 10026 WEST SAN JUAN WAY
CITY: LITTLETON
STATE: CO
ZIP: 80127
BUSINESS PHONE: 303-973-9311
MAIL ADDRESS:
STREET 1: 10026 WEST SAN JUAN WAY
CITY: LITTLETON
STATE: CO
ZIP: 80127
FORMER COMPANY:
FORMER CONFORMED NAME: CPI Holdings I, Inc.
DATE OF NAME CHANGE: 20150506
4
1
a4.xml
4
X0306
4
2017-09-25
0
0001641614
CPI Card Group Inc.
PMTS
0001374969
Scheirman Scott
C/O CPI CARD GROUP INC.
10026 WEST SAN JUAN WAY
LITTLETON
CO
80127
1
0
0
0
Stock Option (Right to Buy)
1.05
2017-09-25
4
A
0
1400000
0
A
2018-09-25
2027-09-25
Common Stock
1400000
1400000
D
Granted in connection with Mr. Scheirman's employment with the Company. Mr. Scheirman will assume the role of Chief Executive Officer of the Company effective October 5, 2017.
The grant of 619,467 options is contingent upon receipt and effectiveness of approval by the Company's stockholders of an amendment to the CPI Card Group Inc. Omnibus Incentive Plan to, among other things, increase the number of shares available for issuance thereunder.
Date at which first vesting occurs is indicated. One-third (1/3) of the original options awarded will vest on each of the first, second and third anniversaries of the September 25, 2017 award date.
/s/Lisa Jacoba, by Power of Attorney
2017-09-27