0001104659-15-083669.txt : 20151208 0001104659-15-083669.hdr.sgml : 20151208 20151208174423 ACCESSION NUMBER: 0001104659-15-083669 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20151201 FILED AS OF DATE: 20151208 DATE AS OF CHANGE: 20151208 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CPI Card Group Inc. CENTRAL INDEX KEY: 0001641614 STANDARD INDUSTRIAL CLASSIFICATION: SHORT-TERM BUSINESS CREDIT INSTITUTIONS [6153] IRS NUMBER: 260344657 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10368 WEST CENTENNIAL ROAD CITY: LITTLETON STATE: CO ZIP: 80127 BUSINESS PHONE: 303-973-9311 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL ROAD CITY: LITTLETON STATE: CO ZIP: 80127 FORMER COMPANY: FORMER CONFORMED NAME: CPI Holdings I, Inc. DATE OF NAME CHANGE: 20150506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fulton Diane CENTRAL INDEX KEY: 0001660117 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37584 FILM NUMBER: 151276534 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL RD. CITY: LITTLETON STATE: CO ZIP: 80127 3 1 a3.xml 3 X0206 3 2015-12-01 0 0001641614 CPI Card Group Inc. PMTS 0001660117 Fulton Diane C/O CPI CARD GROUP INC. 10368 WEST CENTENNIAL ROAD LITTLETON CO 80127 1 0 0 0 Common Stock 4000 I See Footnote Shares of common stock reported on this line are held by Mrs. Fulton's husband. /s/ Lisa Jacoba, by Power of Attorney 2015-12-08 EX-24 2 ex-24.htm EX-24

Exhibit 24

 

POWER OF ATTORNEY

 

Know all by these presents, that the undersigned hereby constitutes and appoints each of Steven Montross, David Brush and Lisa Jacoba, signing singly, the undersigned’s true and lawful attorney-in-fact to:

 

1.              Execute for and on behalf of the undersigned, in the undersigned’s capacity as an officer and/or director of CPI Card Group Inc. (the “Company”), Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules and regulations promulgated thereunder, and the initial insider report, subsequent insider reports and all other forms and reports if required to be filed on SEDI in accordance with National Instrument 55-102 — System for Electronic Disclosure by Insiders (SEDI) and National Instrument 55-104 — Insider Reporting Requirements and Exemptions (collectively, the “Canadian Insider Reports”);

 

2.              Do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, 5 or Canadian Insider Reports, complete and execute any amendment or amendments thereto and timely file such form with the United States Securities and Exchange Commission, any national quotation system, national securities exchange, stock exchange or similar authority and on SEDI; andCPI

 

3.              Take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of or legally required by the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact’s discretion.

 

The undersigned hereby grants to the attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or evocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934 or the applicable Canadian securities legislation.

 

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, 5 and Canadian Insider Reports with respect to the undersigned’s holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact.

 

[signature page follows]

 



 

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 2nd day of December, 2015.

 

 

 

/s/ Diane Fulton

 

Signature

 

 

 

 

 

Diane Fulton

 

Print Name

 

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