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