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