0001144204-17-016457.txt : 20170324 0001144204-17-016457.hdr.sgml : 20170324 20170324130328 ACCESSION NUMBER: 0001144204-17-016457 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161031 FILED AS OF DATE: 20170324 DATE AS OF CHANGE: 20170324 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FARO DIANE CENTRAL INDEX KEY: 0001605299 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35170 FILM NUMBER: 17712008 MAIL ADDRESS: STREET 1: 1175 LANCASTER AVENUE STREET 2: SUITE 100 CITY: BERWYN STATE: PA ZIP: 19312 4 1 v462603_form4.xml OWNERSHIP DOCUMENT X0306 4 2016-10-31 0 0001507986 JetPay Corp JTPY 0001605299 FARO DIANE 3939 WEST DRIVE CENTE VALLEY PA 18034 1 1 0 0 Chief Executive Officer Stock Option (Right to Buy) 2.60 2016-10-31 4 A 0 350000 0 A 2026-11-01 Common Stock 350000 350000 D The stock options vest ratably on a daily basis over the period commencing on October 31, 2016 and ending May 5, 2018. /s/ Gregory M. Krzemien, Attorney in Fact 2017-03-24