0001062993-24-011928.txt : 20240604 0001062993-24-011928.hdr.sgml : 20240604 20240604200850 ACCESSION NUMBER: 0001062993-24-011928 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: Mallela Ravi CENTRAL INDEX KEY: 0001751947 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37584 FILM NUMBER: 241020345 MAIL ADDRESS: STREET 1: C/O NMI HOLDINGS, INC. (NATIONAL MI) STREET 2: 2100 POWELL ST., 12TH FLOOR CITY: EMERYVILLE STATE: CA ZIP: 94608 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CPI Card Group Inc. CENTRAL INDEX KEY: 0001641614 STANDARD INDUSTRIAL CLASSIFICATION: COMMERCIAL PRINTING [2750] ORGANIZATION NAME: 04 Manufacturing IRS NUMBER: 260344657 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10368 WEST CENTENNIAL RD CITY: LITTLETON STATE: CO ZIP: 80127 BUSINESS PHONE: 720-681-6304 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL RD CITY: LITTLETON STATE: CO ZIP: 80127 FORMER COMPANY: FORMER CONFORMED NAME: CPI Holdings I, Inc. DATE OF NAME CHANGE: 20150506 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0508 4 2024-05-31 0001641614 CPI Card Group Inc. PMTS 0001751947 Mallela Ravi C/O CPI CARD GROUP INC. 10368 WEST CENTENNIAL ROAD LITTLETON CO 80127 1 0 0 0 0 Restricted Stock Units 2024-05-31 4 A 0 1067 0 A Common Stock 1067 1067 D This line represents deferred RSUs. The shares of Common Stock underlying these RSUs will be issued to the Reporting Person following the Reporting Person's separation from service with the Issuer. Each restricted stock unit ("RSU") represents the right to receive one common share of the Issuer upon vesting of such RSU. The 1,067 RSUs reported on this line vest on the first anniversary of the May 31, 2024 award date, subject to the reporting person's continued service through such date or as otherwise provided for in the applicable award agreement. Jessica Browne, attorney-in-fact 2024-06-04