0001683168-21-002828.txt : 20210702 0001683168-21-002828.hdr.sgml : 20210702 20210702202709 ACCESSION NUMBER: 0001683168-21-002828 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: Lanford Matthew Louis CENTRAL INDEX KEY: 0001851489 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 211072232 MAIL ADDRESS: STREET 1: 11859 TAVEMA AVE, CITY: LAS VEGAS STATE: NV ZIP: 89138 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 0001851489 Lanford Matthew Louis 2615 ST. ROSE PARKWAY HENDERSON NV 89052 0 1 0 0 COO, President Common Stock 2021-06-30 4 M 0 20000 A 31742 D Stock Grant 2021-06-30 4 M 0 20000 D Common Stock 20000 60000 D On May 31, 2019, the reporting person received a grant of 100,000 shares of common stock vesting annually in equal amounts over a five-year period commencing on June 30, 2020 if employed by the company at that time. As of the date of this filing, 40,000 shares of common stock have vested and been issued. /s/ Matthew Lanford 2021-07-02