0000899243-18-030306.txt : 20181206
0000899243-18-030306.hdr.sgml : 20181206
20181206183133
ACCESSION NUMBER: 0000899243-18-030306
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181206
FILED AS OF DATE: 20181206
DATE AS OF CHANGE: 20181206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Stone Laurence L
CENTRAL INDEX KEY: 0001686923
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35170
FILM NUMBER: 181221882
MAIL ADDRESS:
STREET 1: 725 EAGLE FARM ROAD
CITY: VILLANOVA
STATE: PA
ZIP: 19085
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sundara Investment Partners, LLC
CENTRAL INDEX KEY: 0001686912
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35170
FILM NUMBER: 181221883
BUSINESS ADDRESS:
STREET 1: 725 EAGLE FARM ROAD
CITY: VILLANOVA
STATE: PA
ZIP: 19085
BUSINESS PHONE: 917-603-8293
MAIL ADDRESS:
STREET 1: 725 EAGLE FARM ROAD
CITY: VILLANOVA
STATE: PA
ZIP: 19085
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: JetPay Corp
CENTRAL INDEX KEY: 0001507986
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 900632274
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1175 LANCASTER AVE., SUITE 200
CITY: BERWYN
STATE: PA
ZIP: 19312
BUSINESS PHONE: 6109772482
MAIL ADDRESS:
STREET 1: 1175 LANCASTER AVE., SUITE 200
CITY: BERWYN
STATE: PA
ZIP: 19312
FORMER COMPANY:
FORMER CONFORMED NAME: Universal Business Payment Solutions Acquisition Corp
DATE OF NAME CHANGE: 20101215
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-12-06
0
0001507986
JetPay Corp
JTPY
0001686923
Stone Laurence L
725 EAGLE FARM ROAD
VILLANOVA
PA
19085
1
0
1
0
0001686912
Sundara Investment Partners, LLC
725 EAGLE FARM ROAD
VILLANOVA
PA
19085
0
0
1
0
Common Stock
2018-12-06
4
U
0
13300
D
0
D
Common Stock
2018-12-06
4
U
0
125000
D
0
I
See Footnote
Common Stock
2018-12-06
4
U
0
388573
D
0
I
See Footnote
Common Stock
2018-12-06
4
U
0
336283
D
0
I
See Footnote
Series A Preferred Stock
2.50
2018-12-06
4
U
0
33667
D
Common Stock
4040040
0
I
See Footnote
The common stock was tendered in exchange for $5.05 per share in the tender offer (the "Tender Offer") made pursuant to the Agreement and Plan of Merger, dated as of October 19, 2018, by and among NCR Corporation, Orwell Acquisition Corporation and JetPay Corporation.
Consists of shares of common stock owned by LHLJ, Inc., a Delaware corporation of which Mr. Stone is the sole stockholder.
Consists of shares of common stock owned by Main Line Trading Partners, LLC, a Delaware limited liability company of which Mr. Stone is a managing member and owner of substantially all of the equity interests.
Consists of shares of common stock owned by The Stone Family Trust, an irrevocable trust for the benefit of Mr. Stone's children, of which his wife serves as a trustee.
Prior to the disposition reported hereby, the holders of the Series A Preferred Stock were entitled to convert their shares of Series A Preferred Stock at any time, in whole or in part, into a number of shares of common
stock equal to the quotient determined by dividing (i) the original issue price of $300 per share of Series A Preferred Stock, by (ii) the conversion price, then in effect ("Conversion Price"). The Conversion Price on
December 6, 2018 was $2.50.
Based on the Conversion Price on December 6, 2018.
The Series A Preferred Stock was tendered in exchange for $5.05 per each share of common stock underlying the Series A Preferred Stock in the Tender Offer.
The Series A Preferred Stock is held by Sundara Investment Partners, LLC, of which Mr. Stone is the sole managing member, and, accordingly may also be deemed to have beneficial ownership of such shares.
/s/ Laurence L. Stone
2018-12-06
Sundara Investment Partners, LLC, By: Laurence L. Stone, Managing Member, /s/ Laurence L. Stone
2018-12-06