0001683168-20-003597.txt : 20201029
0001683168-20-003597.hdr.sgml : 20201029
20201029204135
ACCESSION NUMBER: 0001683168-20-003597
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200904
FILED AS OF DATE: 20201029
DATE AS OF CHANGE: 20201029
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Herman Joan M
CENTRAL INDEX KEY: 0001717123
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38623
FILM NUMBER: 201274364
MAIL ADDRESS:
STREET 1: 1700 W. HORIZON RIDGE PARKWAY #200
CITY: HENDERSON
STATE: NV
ZIP: 89012
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
X0306
4
2020-09-04
0
0001496443
Paysign, Inc.
PAYS
0001717123
Herman Joan M
2615 ST. ROSE PKWY
HENDERSON
NV
89052
1
1
0
0
Chief Operating Officer
Common Stock
2020-09-04
2020-09-04
4
A
0
200000
A
719808
D
Common Stock
2020-09-08
2020-09-08
4
F
0
83193
5.7183
D
636615
D
Stock Grant
2020-09-04
2020-09-04
4
C
0
200000
D
Common Stock
200000
D
100% of sale proceeds delivered to company for employee tax withholdings.
On 6/29/17 received grant of 1 million shares of Common Stock. 200k vested on date of employment 9/4/17; 200k vested on each subsequent one year period over four years.
Not applicable.
/s/ Joan M. Herman
2020-09-08