0001683168-21-001844.txt : 20210510 0001683168-21-001844.hdr.sgml : 20210510 20210510125440 ACCESSION NUMBER: 0001683168-21-001844 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210222 FILED AS OF DATE: 20210510 DATE AS OF CHANGE: 20210510 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Baker Jeffery Bradford CENTRAL INDEX KEY: 0001851465 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 21906024 MAIL ADDRESS: STREET 1: 3101 HOWELL MILL RD. STREET 2: UNIT 223 CITY: ATLANTA STATE: GA ZIP: 3 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 3 1 ownership.xml X0206 3 2021-02-22 0 0001496443 Paysign, Inc. PAYS 0001851465 Baker Jeffery Bradford 2615 ST. ROSE PKWY HENDERSON NV 89052 0 1 0 0 CFO Stock Grant Common Stock 300000 D Not Applicable Upon employment, the Company granted Jeffery Baker five equal tranches of sixty thousand restricted common shares each valued at $285,600, which vest annually in equal amounts over a five year period commencing on February 28, 2022, if Jeffery Baker is still employed by the Company at each vesting date. /s/ Jeff Baker 2021-05-06