0001683168-24-003973.txt : 20240604
0001683168-24-003973.hdr.sgml : 20240604
20240604144908
ACCESSION NUMBER: 0001683168-24-003973
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240531
FILED AS OF DATE: 20240604
DATE AS OF CHANGE: 20240604
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Triplett Dennis L
CENTRAL INDEX KEY: 0001740589
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38623
FILM NUMBER: 241017283
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]
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
2024-05-31
0
0001496443
Paysign, Inc.
PAYS
0001740589
Triplett Dennis L
2615 ST. ROSE PARKWAY
HENDERSON
NV
89052
1
0
0
0
0
Common Stock
2024-05-31
4
M
0
20000
4.53
A
230000
D
On May 5, 2023, the reporting person received a grant of 20,000 shares of common stock vesting on May 31, 2024. As of the date of this filing, 20,000 shares of common stock have vested.
/s/ Dennis L. Triplett
2024-06-04