0001683168-21-004686.txt : 20211004
0001683168-21-004686.hdr.sgml : 20211004
20211004195006
ACCESSION NUMBER: 0001683168-21-004686
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210930
FILED AS OF DATE: 20211004
DATE AS OF CHANGE: 20211004
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: 211304701
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
2021-09-30
0
0001496443
Paysign, Inc.
PAYS
0001506415
Newcomer Mark
2615 ST. ROSE PARKWAY
HENDERSON
NV
89052
1
1
1
0
CEO
Common Stock
2021-09-30
4
M
0
100000
2.70
A
9422492
D
Common Stock
2021-10-01
4
S
0
38828
2.576
D
9383664
D
Common Stock
2021-10-04
4
S
0
2462
2532
D
9381202
D
Stock Grant
2021-09-30
4
M
0
100000
D
Common Stock
100000
0
D
On November 11, 2016, the reporting person received a grant of 2,000,000 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, 2,000,000 shares of common stock have vested and been issued.
These shares of common stock were sold to satisfy certain tax withholding obligations associated with the vesting of restricted stock.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $2.48 to $2.62, inclusive. The reporting person undertakes to provide to Paysign, Inc. (the "Company"), any security holder of the Company, or the staff of the Securities and Exchange Commission (the "SEC"), upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $2.51 to $2.57, inclusive. The reporting person undertakes to provide to the Company, any security holder of the Company, or the staff of the SEC, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
/s/ Mark Newcomer
2021-10-04