0001209191-21-036568.txt : 20210528 0001209191-21-036568.hdr.sgml : 20210528 20210528165226 ACCESSION NUMBER: 0001209191-21-036568 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210528 FILED AS OF DATE: 20210528 DATE AS OF CHANGE: 20210528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Trainor Gary CENTRAL INDEX KEY: 0001863391 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40429 FILM NUMBER: 21981232 MAIL ADDRESS: STREET 1: 18390 NE 68TH ST. CITY: REDMOND STATE: WA ZIP: 98052 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: 18390 NE 68TH ST. CITY: REDMOND STATE: WA ZIP: 98052 BUSINESS PHONE: (888) 440-4826 MAIL ADDRESS: STREET 1: 18390 NE 68TH ST. CITY: REDMOND STATE: WA ZIP: 98052 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-05-28 0 0001841156 Paymentus Holdings, Inc. PAY 0001863391 Trainor Gary 18390 NE 68TH ST. REDMOND WA 98052 1 0 0 0 Stock Option (Right to Buy) 0.03 2021-05-28 4 J 0 1477715 0.00 D 2022-10-10 Common Stock 1477715 0 I See Explanation of Responses Stock Option (Right to Buy) 0.03 2021-05-28 4 J 0 1477715 0.00 A 2022-10-10 Class B Common Stock 1477715 1477715 I See Explanation of Responses Pursuant to a reclassification exempt under Rule 16b-7, each share of Common Stock was automatically reclassified into one share of Class B Common Stock immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock. 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. The shares subject to the option are fully vested and exercisable. Represents shares held directly by TF Investment Holdings LLC. Gary Trainor is the sole manager of TF Investment Holdings LLC and has sole voting and dispositive power with respect to the shares held by TF Investment Holdings LLC. /s/ John Morrow, Attorney-in-Fact 2021-05-28