0001104659-16-102762.txt : 20160304 0001104659-16-102762.hdr.sgml : 20160304 20160304211634 ACCESSION NUMBER: 0001104659-16-102762 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160302 FILED AS OF DATE: 20160304 DATE AS OF CHANGE: 20160304 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: Jacoba Lisa CENTRAL INDEX KEY: 0001654465 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37584 FILM NUMBER: 161486786 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL RD. CITY: LITTLETON STATE: CO ZIP: 80127 4 1 a4.xml 4 X0306 4 2016-03-02 0 0001641614 CPI Card Group Inc. PMTS 0001654465 Jacoba Lisa C/O CPI CARD GROUP INC. 10368 WEST CENTENNIAL ROAD LITTLETON CO 80127 0 1 0 0 Chief Human Resources Officer Stock Option (Right to Buy) 10 2016-03-02 4 A 0 21000 0 A 2017-10-08 2025-10-08 Common Stock 21000 52000 D Restricted Stock Units 2016-03-02 4 A 0 12642 0 A Common Stock 12642 12642 D Date at which first vesting occurs is indicated. Subject to the insider's continued employment, approximately one third (1/3) of the original options granted will vest on each of the second, third and fourth anniversaries of October 8, 2015. Each Restricted Stock Unit represents the right to receive one CPI Card Group Inc. common share upon vesting of such Restricted Stock Unit. The Restricted Stock Units vest on the first anniversary of the March 2, 2016 grant date. /s/ Lisa Jacoba 2016-03-04