0001683168-21-002827.txt : 20210702 0001683168-21-002827.hdr.sgml : 20210702 20210702202437 ACCESSION NUMBER: 0001683168-21-002827 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210630 FILED AS OF DATE: 20210702 DATE AS OF CHANGE: 20210702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Spence Daniel CENTRAL INDEX KEY: 0001506497 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 211072229 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 2021-06-30 0 0001496443 Paysign, Inc. PAYS 0001506497 Spence Daniel 2615 ST. ROSE PARKWAY HENDERSON NV 89052 1 1 1 0 EVP Common Stock 2021-06-30 4 M 0 100000 A 9290000 D Stock Grant 2021-06-30 4 M 0 100000 D Common Stock 100000 100000 D On 11/11/16, the reporting person received a 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 the company at that time. As of the date of this filing, 1.9 million shares have vested and been issued. /s/ Daniel Spence 2021-07-02