0001683168-21-001095.txt : 20210330 0001683168-21-001095.hdr.sgml : 20210330 20210330163739 ACCESSION NUMBER: 0001683168-21-001095 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210329 FILED AS OF DATE: 20210330 DATE AS OF CHANGE: 20210330 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mina Bruce A CENTRAL INDEX KEY: 0001736843 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 21786380 MAIL ADDRESS: STREET 1: 1700 W. HORIZON RIDGE PKWY, #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 2021-03-29 0 0001496443 Paysign, Inc. PAYS 0001736843 Mina Bruce A 2615 SAINT ROSE PARKWAY HENDERSON NV 89052 1 0 0 0 Common Stock 2021-03-29 2021-03-29 4 A 0 50000 A 155500 D Stock Grant 2021-03-29 2021-03-29 4 C 0 50000 D Common Stock 50000 D On March 29, 2018, the Director received 200,000 shares of Common Stock, vesting in equal parts over a 4 year period on each anniversary date in which the Director is still serving in his capacity as Director. Not applicable. /s/ Bruce A. Mina 2021-03-30