0001493152-19-011057.txt : 20190724
0001493152-19-011057.hdr.sgml : 20190724
20190724180134
ACCESSION NUMBER: 0001493152-19-011057
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: Chan Heng Fai Ambrose
CENTRAL INDEX KEY: 0001261725
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32146
FILM NUMBER: 19971951
MAIL ADDRESS:
STREET 1: 2601 INSLAND PLACE TOWER
STREET 2: 510 KINGS RD N POINT
CITY: HONG KONG
STATE: K3
ZIP: 999999999
FORMER NAME:
FORMER CONFORMED NAME: CHAN FAI
DATE OF NAME CHANGE: 20030828
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
0001261725
Chan Heng Fai Ambrose
C/O DOCUMENT SECURITY SYSTEMS, INC.
200 CANAL VIEW BLVD., SUITE 300
ROCHESTER
NY
14623
1
0
1
0
Common Stock
2019-07-23
4
A
0
74770
0
A
2077682
D
Represents a restricted 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 Executive Chairman of the Issuer and Executive Chairman and Chief Executive Officer of the Issuer's subsidiary.
/s/ Heng Fai Ambrose Chan
2019-07-24