0001683168-21-001201.txt : 20210401 0001683168-21-001201.hdr.sgml : 20210401 20210401205127 ACCESSION NUMBER: 0001683168-21-001201 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210331 FILED AS OF DATE: 20210401 DATE AS OF CHANGE: 20210401 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Newcomer Mark CENTRAL INDEX KEY: 0001506415 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 21800294 MAIL ADDRESS: STREET 1: 1700 W HORIZON RIDGE PARKWAY STE 2 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 2021-03-31 0 0001496443 Paysign, Inc. PAYS 0001506415 Newcomer Mark 2615 ST. ROSE PARKWAY HENDERSON NV 89052 1 1 1 0 CEO Common Stock 2021-03-31 2021-03-31 4 A 0 100000 A 9278018 D Stock Grant 2021-03-31 2021-03-31 4 C 0 100000 D Common Stock 300000 D On 11/11/16 received grant of 2 million shares of Common Stock vesting in equal amounts over a 5 year period on the last day of each quarter if employed by company at that time. As of the date of this filing, 1.7 million shares have vested. Not applicable. /s/ Mark Newcomer 2021-04-01