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