0001683168-24-001260.txt : 20240304 0001683168-24-001260.hdr.sgml : 20240304 20240304075122 ACCESSION NUMBER: 0001683168-24-001260 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240228 FILED AS OF DATE: 20240304 DATE AS OF CHANGE: 20240304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Baker Jeffery Bradford CENTRAL INDEX KEY: 0001851465 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38623 FILM NUMBER: 24712871 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] ORGANIZATION NAME: 07 Trade & Services 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 2024-02-28 0 0001496443 Paysign, Inc. PAYS 0001851465 Baker Jeffery Bradford 2615 ST. ROSE PKWY HENDERSON NV 89052 0 1 0 0 Chief Financial Officer 0 Common Stock 2024-02-28 4 M 0 60000 0.00 A 184788 D Stock Grant 2024-02-28 4 M 0 60000 0.00 D 2026-02-28 Common Stock 60000 120000 D One-fifth of the restricted stock shall vest annually on each anniversary of the February 28, 2021 vesting commencement date until fully vested on February 28, 2026. /s/ Jeffery Baker 2024-03-01