0001209191-21-071088.txt : 20211223
0001209191-21-071088.hdr.sgml : 20211223
20211223170014
ACCESSION NUMBER: 0001209191-21-071088
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211223
FILED AS OF DATE: 20211223
DATE AS OF CHANGE: 20211223
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jackson Michael Frank
CENTRAL INDEX KEY: 0001782283
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38531
FILM NUMBER: 211517796
MAIL ADDRESS:
STREET 1: 3 WEST PACES FERRY ROAD, SUITE 200
CITY: ATLANTA
STATE: GA
ZIP: 30305
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Repay Holdings Corp
CENTRAL INDEX KEY: 0001720592
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 000000000
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3 WEST PACES FERRY ROAD
STREET 2: SUITE 200
CITY: ATLANTA
STATE: GA
ZIP: 30305
BUSINESS PHONE: (404) 504-7474
MAIL ADDRESS:
STREET 1: 3 WEST PACES FERRY ROAD
STREET 2: SUITE 200
CITY: ATLANTA
STATE: GA
ZIP: 30305
FORMER COMPANY:
FORMER CONFORMED NAME: Thunder Bridge Acquisition Ltd
DATE OF NAME CHANGE: 20171024
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-12-23
0
0001720592
Repay Holdings Corp
RPAY
0001782283
Jackson Michael Frank
C/O REPAY HOLDINGS CORPORATION,
3 WEST PACES FERRY ROAD, SUITE 200
ATLANTA
GA
30305
0
1
0
0
Chief Operating Officer
Class A Common Stock
2021-12-23
4
F
0
705
18.37
D
88038
D
Class A Common Stock
117269
I
See footnote
Reflects shares of Class A common stock of the Issuer withheld to cover the Reporting Person's tax liability in connection with the vesting of shares of time-based restricted stock previously reported by the Reporting Person.
These securities are held directly by limited liability companies. For each such limited liability company, (a) Reporting Person serves as the sole member of its board of managers and (b) all of the voting ownership interests are owned by Reporting Person (in his capacity as trustee of a revocable trust).
The Reporting Person disclaims beneficial ownership of any securities reported herein as indirectly beneficially owned, except to the extent of his pecuniary interest therein.
/s/ Timothy J. Murphy, as Attorney-in-Fact
2021-12-23