0001209191-22-036060.txt : 20220610 0001209191-22-036060.hdr.sgml : 20220610 20220610174843 ACCESSION NUMBER: 0001209191-22-036060 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220609 FILED AS OF DATE: 20220610 DATE AS OF CHANGE: 20220610 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: 221010091 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 2022-06-09 0 0001841156 Paymentus Holdings, Inc. PAY 0001863391 Trainor Gary 18390 NE 68TH ST. REDMOND WA 98052 1 0 0 0 Class A Common Stock 2022-06-09 4 C 0 1189888 0.00 A 1289888 I See Explanation of Responses Class A Common Stock 2022-06-09 4 S 0 620000 13.68 D 669888 I See Explanation of Responses Stock Option (Right to Buy) 0.03 2022-06-09 4 M 0 1189888 0.00 D 2022-10-10 Class B Common Stock 1189888 0 I See Explanation of Responses Class B Common Stock 2022-06-09 4 M 0 1189888 0.00 A Class A Common Stock 1189888 1189888 I See Explanation of Responses Class B Common Stock 2022-06-09 4 C 0 1189888 0.00 D Class A Common Stock 1189888 0 I See Explanation of Responses Represents the conversion of Class B Common Stock into Class A Common Stock held of record by TF Investment Holdings LLC. 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. The shares subject to the option are fully vested and exercisable. 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 Gerber, Attorney-in-Fact 2022-06-10