0001683168-21-001199.txt : 20210401 0001683168-21-001199.hdr.sgml : 20210401 20210401204841 ACCESSION NUMBER: 0001683168-21-001199 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210330 FILED AS OF DATE: 20210401 DATE AS OF CHANGE: 20210401 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Attinger Mark Kenneth CENTRAL INDEX KEY: 0001742593 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 21800275 MAIL ADDRESS: STREET 1: 34522 N.SCOTTSDALE ROAD, SUITE 120-492 CITY: SCOTTSDALE STATE: AZ ZIP: 85266 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 2021-03-30 0 0001496443 Paysign, Inc. PAYS 0001742593 Attinger Mark Kenneth 2615 ST. ROSE PKWY HENDERSON NV 89052 0 0 0 1 Former Officer Common Stock 2021-03-30 2021-03-30 4 S 0 80000 4.1210 D 26084 D Stock Grant 2021-03-31 2021-03-31 4 J 0 180000 D Common Stock 90000 D Stock Options 3.87 2021-03-31 2021-03-31 4 J 0 75000 D Common Stock 25000 D On 10/29/18 received grant of 450,000 shares of Common Stock vesting in equal amounts over a 5 year period on the last day of October if employed by company at that time. Not applicable. On 3/23/20 received an option to purchase 100,000 shares of Common Stock for 10 years at $3.87, vesting in equal parts over a 4-year period annually during his service as an employee. J - the cancellation of unvested shares and options at the end of employment. /s/ Mark Attinger 2021-04-01