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