0000950170-23-065680.txt : 20231121
0000950170-23-065680.hdr.sgml : 20231121
20231121210006
ACCESSION NUMBER: 0000950170-23-065680
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231120
FILED AS OF DATE: 20231121
DATE AS OF CHANGE: 20231121
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Klein Jason
CENTRAL INDEX KEY: 0001863374
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40429
FILM NUMBER: 231429756
MAIL ADDRESS:
STREET 1: C/O ACCEL-KKR
STREET 2: 2180 SAND HILL ROAD, SUITE 300
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Paymentus Holdings, Inc.
CENTRAL INDEX KEY: 0001841156
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11605 N. COMMUNITY HOUSE ROAD
STREET 2: SUITE 300
CITY: CHARLOTTE
STATE: NC
ZIP: 28277
BUSINESS PHONE: (888) 440-4826
MAIL ADDRESS:
STREET 1: 11605 N. COMMUNITY HOUSE ROAD
STREET 2: SUITE 300
CITY: CHARLOTTE
STATE: NC
ZIP: 28277
4
1
ownership.xml
4
X0508
4
2023-11-20
0001841156
Paymentus Holdings, Inc.
PAY
0001863374
Klein Jason
C/O ACCEL-KKR
2180 SAND HILL ROAD, SUITE 300
MENLO PARK
CA
94025
true
false
false
false
false
Class B Common Stock
2023-11-20
5
J
false
12024
0.00
A
Class A Common Stock
12024
12024
I
See footnote
Class B Common Stock is convertible at any time, at the holder's election and automatically in connection with certain transfers and upon certain other events, into an equal number of shares of Class A Common Stock and has no expiration date.
Shares received in a pro rata distribution from funds affiliated with Accel-KKR. The acquisition of such shares was exempt pursuant to Rule 16a-9(a) under the Securities Exchange Act of 1934, as amended.
Shares held by The Jason and Farah Klein Revocable Trust dtd 1/27/2011.
/s/ Jason Klein
2023-11-21