0001493152-19-011052.txt : 20190724 0001493152-19-011052.hdr.sgml : 20190724 20190724175806 ACCESSION NUMBER: 0001493152-19-011052 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190723 FILED AS OF DATE: 20190724 DATE AS OF CHANGE: 20190724 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Scott Brett L CENTRAL INDEX KEY: 0001405195 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32146 FILM NUMBER: 19971938 MAIL ADDRESS: STREET 1: 15770 LAGUNA CANYON ROAD STREET 2: SUITE 150 CITY: IRVINE STATE: CA ZIP: 92618 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOCUMENT SECURITY SYSTEMS INC CENTRAL INDEX KEY: 0000771999 STANDARD INDUSTRIAL CLASSIFICATION: PAPERBOARD CONTAINERS & BOXES [2650] IRS NUMBER: 161229730 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 CANAL VIEW BOULEVARD STREET 2: SUITE 300 CITY: ROCHESTER STATE: NY ZIP: 14623 BUSINESS PHONE: 585 232 1500 MAIL ADDRESS: STREET 1: 200 CANAL VIEW BOULEVARD STREET 2: SUITE 300 CITY: ROCHESTER STATE: NY ZIP: 14623 FORMER COMPANY: FORMER CONFORMED NAME: NEW SKY COMMUNICATIONS INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: THOROUGHBREDS USA INC DATE OF NAME CHANGE: 19861118 4 1 ownership.xml X0306 4 2019-07-23 0 0000771999 DOCUMENT SECURITY SYSTEMS INC DSS 0001405195 Scott Brett L C/O DOCUMENT SECURITY SYSTEMS, INC 200 CANAL VIEW BLVD, SUITE 300 ROCHESTER NY 14623 1 0 0 0 Common Stock 2019-07-23 4 A 0 30575 0 A 30575 D Represents a stock grant awarded to the Reporting Person by the Issuer pursuant to the Company's 2013 Employee, Director and Consultants Equity Incentive Plan in consideration for the Reporting Person's services as a Director of the Issuer. /s/ Brett L. Scott 2019-07-24