0001209191-22-030488.txt : 20220519 0001209191-22-030488.hdr.sgml : 20220519 20220519160621 ACCESSION NUMBER: 0001209191-22-030488 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220518 FILED AS OF DATE: 20220519 DATE AS OF CHANGE: 20220519 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Portocalis Gerasimos (Jerry) CENTRAL INDEX KEY: 0001863390 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40429 FILM NUMBER: 22942863 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 2022-05-18 0 0001841156 Paymentus Holdings, Inc. PAY 0001863390 Portocalis Gerasimos (Jerry) 18390 NE 68TH ST. REDMOND WA 98052 0 1 0 0 Chief Commercial Officer Class A Common Stock 2022-05-18 4 C 0 26667 0.00 A 397536 D Stock Option (right to buy) 8.66 2022-05-18 4 M 0 26667 8.66 D 2029-08-27 Class B Common Stock 26667 23333 D Class B Common Stock 2022-05-18 4 M 0 26667 0.00 A Class A Common Stock 26667 26667 D Class B Common Stock 2022-05-18 4 C 0 26667 0.00 D Class A Common Stock 26667 0 D Represents the conversion of Class B Common Stock into Class A Common Stock. One sixtieth (1/60th) of the shares subject to the award vested on September 30, 2019, and one sixtieth (1/60th) of the shares subject to the award vest on the last day of each month thereafter. 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. /s/ Andrew A. Gerber, Attorney-in-Fact 2022-05-19