0001683168-23-003822.txt : 20230601 0001683168-23-003822.hdr.sgml : 20230601 20230601200104 ACCESSION NUMBER: 0001683168-23-003822 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230601 FILED AS OF DATE: 20230601 DATE AS OF CHANGE: 20230601 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HENRY DANIEL R CENTRAL INDEX KEY: 0001253706 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 23986329 MAIL ADDRESS: STREET 1: 13160 BIRCH CITY: OVERLAND PARK STATE: KS ZIP: 66211 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 X0407 4 2023-06-01 0 0001496443 Paysign, Inc. PAYS 0001253706 HENRY DANIEL R 2615 ST. ROSE PARKWAY HENDERSON NV 89052 1 0 0 0 0 Common Stock 2023-06-01 2023-06-01 4 A 0 50000 2.5175 A 50000 D /s/ Daniel R. Henry 2023-06-01