0000899243-19-001221.txt : 20190115 0000899243-19-001221.hdr.sgml : 20190115 20190115162634 ACCESSION NUMBER: 0000899243-19-001221 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181231 FILED AS OF DATE: 20190115 DATE AS OF CHANGE: 20190115 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: York Jeffrey D. CENTRAL INDEX KEY: 0001594541 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36393 FILM NUMBER: 19527343 MAIL ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Paycom Software, Inc. CENTRAL INDEX KEY: 0001590955 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 800957485 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 BUSINESS PHONE: (405) 722-6900 MAIL ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2018-12-31 0 0 0 0001590955 Paycom Software, Inc. PAYC 0001594541 York Jeffrey D. 7501 W. MEMORIAL ROAD OKLAHOMA CITY OK 73142 0 1 0 0 Chief Sales Officer Common Stock 2018-12-10 5 G 0 22000 0.00 D 0 I By York Charitable Remainder Unitrust Common Stock 563231 I By JCY Holdings, LP Common Stock 157097 D The York Charitable Remainder Unitrust is a charitable remainder trust of which the reporting person and his spouse are co-trustees and of which the reporting person and his spouse are beneficiaries. The general partner of JCY Holdings, LP ("JCY Holdings") is JCY General LLC ("JCY General") and the limited partners of JCY Holdings are the reporting person and his spouse. Each of the reporting person and his spouse owns 50% of the membership interests of JCY General. Includes 24,000 unvested shares of restricted stock. /s/ Jeffrey D. York 2019-01-11