0001683168-22-003204.txt : 20220504
0001683168-22-003204.hdr.sgml : 20220504
20220504192724
ACCESSION NUMBER: 0001683168-22-003204
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220503
FILED AS OF DATE: 20220504
DATE AS OF CHANGE: 20220504
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Triplett Dennis L
CENTRAL INDEX KEY: 0001740589
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38623
FILM NUMBER: 22893398
MAIL ADDRESS:
STREET 1: 1700 HORIZON RIDGE PARKWAY, #200
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
2022-05-03
0
0001496443
Paysign, Inc.
PAYS
0001740589
Triplett Dennis L
2615 SAINT ROSE PARKWAY
HENDERSON
NV
89052
1
0
0
0
Common Stock
2022-05-03
4
A
0
50000
A
200000
D
Stock Grant
2022-05-03
2022-05-03
4
M
0
50000
D
Common Stock
0
D
On May 3, 2018, Mr. Triplett received a grant of 200,000 shares of Common Stock, vesting in equal parts over a 4 year period on each anniversary date on which Mr. Triplett is still serving as a director
Not applicable
/s/ Dennis L. Triplett
2022-05-03