0001104659-17-061167.txt : 20171005 0001104659-17-061167.hdr.sgml : 20171005 20171005170813 ACCESSION NUMBER: 0001104659-17-061167 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171003 FILED AS OF DATE: 20171005 DATE AS OF CHANGE: 20171005 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tavares Silvio CENTRAL INDEX KEY: 0001685787 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37584 FILM NUMBER: 171125212 MAIL ADDRESS: STREET 1: C/O CPI CARD GROUP INC. STREET 2: 10368 WEST CENTENNIAL RD. CITY: LITTLETON STATE: CO ZIP: 80127 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: 10026 WEST SAN JUAN WAY CITY: LITTLETON STATE: CO ZIP: 80127 BUSINESS PHONE: 303-973-9311 MAIL ADDRESS: STREET 1: 10026 WEST SAN JUAN WAY CITY: LITTLETON STATE: CO ZIP: 80127 FORMER COMPANY: FORMER CONFORMED NAME: CPI Holdings I, Inc. DATE OF NAME CHANGE: 20150506 4 1 a4.xml 4 X0306 4 2017-10-03 0 0001641614 CPI Card Group Inc. PMTS 0001685787 Tavares Silvio C/O CPI CARD GROUP INC. 10026 WEST SAN JUAN WAY LITTLETON CO 80127 1 0 0 0 Common Stock 2017-10-03 4 M 0 6209 A 31209 D Restricted Stock Units 2017-10-03 4 M 0 6209 0 D Common Stock 6209 25000 D Each restricted stock unit represents the right to receive one CPI Card Group Inc. common share upon vesting of such restricted stock unit. On October 3, 2016, the reporting person was granted 6,209 restricted stock units, vesting on the first anniversary of the grant date. Total includes prior restricted stock unit awards that have different vesting and expiration dates. /s/ Lisa Jacoba, by Power of Attorney 2017-10-05