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