0001683168-23-001264.txt : 20230302
0001683168-23-001264.hdr.sgml : 20230302
20230302204840
ACCESSION NUMBER: 0001683168-23-001264
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230228
FILED AS OF DATE: 20230302
DATE AS OF CHANGE: 20230302
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Baker Jeffery Bradford
CENTRAL INDEX KEY: 0001851465
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38623
FILM NUMBER: 23701418
MAIL ADDRESS:
STREET 1: 3101 HOWELL MILL RD.
STREET 2: UNIT 223
CITY: ATLANTA
STATE: GA
ZIP: 3
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
2023-02-28
0
0001496443
Paysign, Inc.
PAYS
0001851465
Baker Jeffery Bradford
2615 ST. ROSE PKWY
HENDERSON
NV
89052
0
1
0
0
Chief Financial Officer
Common Stock
2023-02-28
4
M
0
60000
3.88
A
118693
D
Common Stock
2023-03-01
4
S
0
27232
3.70
D
91461
D
On January 6, 2021, the reporting person received a grant of 300,000 shares of common stock vesting annually in equal amounts over a five-year period commencing on February 28, 2022. As of the date of this filing, 120,000 shares of common stock have vested and been issued.
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.
These shares of common stock were sold to satisfy certain tax withholding obligations associated with the vesting of restricted stock.
/s/ Jeff Baker
2023-03-02