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