0001683168-23-005225.txt : 20230802 0001683168-23-005225.hdr.sgml : 20230802 20230802215949 ACCESSION NUMBER: 0001683168-23-005225 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230731 FILED AS OF DATE: 20230802 DATE AS OF CHANGE: 20230802 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: 231137810 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 X0508 4 2023-07-31 0 0001496443 Paysign, Inc. PAYS 0001851465 Baker Jeffery Bradford 2615 ST. ROSE PKWY HENDERSON NV 89052 0 1 0 0 Chief Financial Officer 0 Common Stock 2023-07-31 4 M 0 64000 0.00 A 155461 D Common Stock 2023-08-01 4 S 0 9928 1.8836 D 145533 D Common Stock 2023-08-02 4 S 0 8701 1.8151 D 136832 D Stock Grant 2023-07-31 4 M 0 64000 0.00 D 2027-07-31 Common stock 64000 256000 D On July 26, 2022, the reporting person received a grant of 320,000 shares of common stock vesting annually in equal amounts over a five-year period commencing on July 31, 2023. As of the date of this filing, 64,000 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 $1.85 to $1.97, 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 $1.79 to $1.87, 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/ Jeff B. Baker 2023-08-02