0001209191-21-068258.txt : 20211207 0001209191-21-068258.hdr.sgml : 20211207 20211207103252 ACCESSION NUMBER: 0001209191-21-068258 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211201 FILED AS OF DATE: 20211207 DATE AS OF CHANGE: 20211207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kaul Priyanka CENTRAL INDEX KEY: 0001861079 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-15946 FILM NUMBER: 211474958 MAIL ADDRESS: STREET 1: 1 EBIX WAY CITY: JOHNS CREEK STATE: GA ZIP: 30097 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EBIX INC CENTRAL INDEX KEY: 0000814549 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 770021975 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 EBIX WAY CITY: JOHNS CREEK STATE: GA ZIP: 30097 BUSINESS PHONE: 678-281-2020 MAIL ADDRESS: STREET 1: 1 EBIX WAY CITY: JOHNS CREEK STATE: GA ZIP: 30097 FORMER COMPANY: FORMER CONFORMED NAME: EBIX COM INC DATE OF NAME CHANGE: 19991115 FORMER COMPANY: FORMER CONFORMED NAME: DELPHI INFORMATION SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19920703 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-12-01 0 0000814549 EBIX INC EBIX 0001861079 Kaul Priyanka 1 EBIX WAY JOHNS CREEK GA 30097 1 0 0 0 option to purchase common stock 30.40 2021-12-01 4 A 0 6000 0.00 A 2022-12-01 2025-12-01 Common Stock 6000 6000 D The stock options will become exercisable 1/4 on the first anniversary of the date of grant with the remaining options vesting ratably on the first day of each quarter over the next three years. /s/ Priyanka Kaul 2021-12-07