SEC Form 4 · accession 0001415889-17-000033
PAID INC · PAYD:OTC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
William Austin Lewis IV
Officer — PRESIDENT AND CFO · Director
Period of report
Dec 30, 2016
Accepted (ET)
Jan 4, 2017 · 6:36 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001017655
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jan 2, 2017 | A | 77,121 | $1.46 | A | 257,121 | I | By Lewis Asset Mgmt. Corp. |
| Preferred StockF1 | Jan 2, 2017 | A | 536,346 | $1.46 | A | 536,346 | I | By Lewis Asset Mgmt. Corp. |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Exchangeable Shares (Right to Convert to Common)F2,F1,F3 | — | Dec 30, 2016 | A | 77,121 | A | Dec 30, 2016 | Dec 30, 2021 | Common Stock | 77,121 | 77,121 | I |
| Exchangeable Shares (Right to Convert to Preferred)F2,F1,F3 | — | Dec 30, 2016 | A | 536,346 | A | Dec 30, 2016 | Dec 30, 2021 | Common Stock | 536,346 | 536,346 | I |
| Exchangeable Shares (Right to Convert to Common)F2,F1,F3 | — | Jan 2, 2017 | D | 77,121 | D | Dec 30, 2016 | Dec 30, 2021 | Common Stock | 77,121 | 77,121 | I |
| Exchangeable Shares (Right to Convert to Preferred)F2,F1,F3 | — | Jan 2, 2017 | D | 536,346 | D | Dec 30, 2016 | Dec 30, 2021 | Common Stock | 536,346 | 536,346 | I |
| Warrant (Right to Buy Exchgble Shares Convtble into Common)F2,F1 | $1.46 | Dec 30, 2016 | A | 34,425 | A | Dec 30, 2016 | Dec 30, 2021 | Common Stock | 34,425 | 34,425 | I |
| Warrant (Right to Buy Exchgble Shares Convtble into Common)F2,F1 | $1.46 | Dec 30, 2016 | A | 239,412 | A | Dec 30, 2016 | Dec 30, 2021 | Common Stock | 239,412 | 239,412 | I |
Explanation of responses
- F1All numbers reflect a reverse split of 1:3000 followed by an immediate forward split of 300:1 effective on December 30, 2016.
- F2Exchangeable shares are rights to PAID, Inc.'s common stock and preferred stock. These rights can be exercised by the conversion of the exchangeable shares into shares of common and preferred stock of PAID Inc. in accordance with an Exchange and Call Rights Agreement filed as Appendix I to its Consent Solicitation Statement on Form 14A of PAID Inc. filed on October, 7 2016. Mr. Lewis may exercise his exchangeable rights as specified in the Exchange and Call Rights Agreement. The Preferred stock of PAID, Inc. is non-voting.
- F3Merger consideration equal to a valuation at $1.46 per share.