0001415889-17-001721.txt : 20171026 0001415889-17-001721.hdr.sgml : 20171026 20171026210913 ACCESSION NUMBER: 0001415889-17-001721 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170630 FILED AS OF DATE: 20171026 DATE AS OF CHANGE: 20171026 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FIELDS RANDALL K CENTRAL INDEX KEY: 0001143335 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34941 FILM NUMBER: 171157680 MAIL ADDRESS: STREET 1: 3160 PINEBROOK ROAD CITY: PARK CITY STATE: UT ZIP: 84098 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PARK CITY GROUP INC CENTRAL INDEX KEY: 0000050471 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 371454128 STATE OF INCORPORATION: NV FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 299 S. MAIN STREET STREET 2: SUITE 2225 CITY: SALT LAKE CITY STATE: UT ZIP: 84111 BUSINESS PHONE: 435-645-2100 MAIL ADDRESS: STREET 1: 299 S. MAIN STREET STREET 2: SUITE 2225 CITY: SALT LAKE CITY STATE: UT ZIP: 84111 FORMER COMPANY: FORMER CONFORMED NAME: FIELDS TECHNOLOGIES INC DATE OF NAME CHANGE: 20010626 FORMER COMPANY: FORMER CONFORMED NAME: AMERINET GROUP COM INC DATE OF NAME CHANGE: 19990803 FORMER COMPANY: FORMER CONFORMED NAME: EQUITY GROWTH SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19951214 5 1 form5-10262017_061002.xml X0306 5 2017-06-30 0 1 0000050471 PARK CITY GROUP INC PCYG 0001143335 FIELDS RANDALL K C/O PARK CITY GROUP, INC. 299 SOUTH MAIN STREET, SUITE 2225 SALT LAKE CITY UT 84111 true true true false CHIEF EXECUTIVE OFFICER Common Stock 2016-07-05 5 A 0 554 7.62 A 3698056 D Common Stock 2016-12-30 5 G 0 2074 0 D 3698056 D Common Stock 2017-01-18 5 A 0 586 7.76 A 3698056 D Common Stock 2017-01-25 5 G 0 12258 0 D 3698056 D Common Stock 2017-03-01 5 G 0 1976 0 D 3698056 D Series B-1 Preferred Stock 2016-07-05 4 A 0 10000 0 A 115788 I By Fields Management, Inc. Series B-1 Preferred Stock 2017-03-31 4 A 0 20000 0 A 115788 I By Fields Management, Inc. Common Stock 650693 I By Riverview Financial Corp. Common Stock 30667 I By Spouse Common Stock 1289230 I By Fields Management Series B Preferred Stock 531432 I By Riverview Financial Corp Series B Preferred Stock 14450 I By Spouse Common Stock 205000 I By Charitable 2010, LLC Series B-1 Preferred Stock 147370 I By Riverview Financial Corp Series B-1 Preferred Stock 657 I By Spouse Warrant 3.60 2013-03-14 2018-03-14 Common Stock 6875 6875 D Warrant 10 2015-01-26 2020-01-26 Common Stock 3165 3165 D Warrants 4 2015-02-05 2020-02-05 Common Stock 914065 914065 I By Riverview Financial Corp Warrant 4 2015-02-05 2020-02-05 Common Stock 40250 40250 I By Spouse Shares issued in lieu of cash compensation at a 15% discount to fair market value, pursuant to the Issuer's 2011 Employee Stock Purchase Plan. Includes 5,157 unvested shares of common stock. Shares issued as payment of a bonus granted to Fields Management, Inc., a management company wholly-owned by the Reporting Person ("FMI"), by the Compensation Committee of the Issuer's Board of Directors, pursuant to the Employment Agreement by and between the Issuer and FMI, dated June 30, 2013, pursuant to which the Reporting Person serves as the Issuer's Chief Executive Officer. Amount includes shares of Series B-1 Preferred issued to the Reporting Person during the year ended June 30, 2017 as payment-in-kind of accrued dividends. Includes 771,587 unvested shares of common stock. /s/ Randall K. Fields 2017-10-26