SEC Form 5 · accession 0001538843-17-000028
EPAM Systems, Inc. · EPAM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Arkadiy Dobkin
Officer — CEO, President, Chairman · Director
Period of report
Dec 31, 2016
Accepted (ET)
Jul 14, 2017 · 4:32 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001352010
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| EPAM Common Stock | Dec 26, 2013 | G | 2,000 | $0.00 | D | 2,118,164 | D | |
| EPAM Common StockF2 | Dec 26, 2013 | G | 2,000 | $0.00 | A | 515,400 | I | See footnote |
| EPAM Common Stock | Dec 30, 2015 | G | 1,005 | $0.00 | D | 2,117,159 | D | |
| EPAM Common StockF2 | Dec 30, 2015 | G | 1,005 | $0.00 | A | 516,405 | I | See footnote |
| EPAM Common Stock | Dec 30, 2016 | G | 1,308 | $0.00 | D | 2,115,851 | D | |
| EPAM Common StockF2 | Dec 30, 2016 | G | 1,308 | $0.00 | A | 517,713 | I | See footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1This transaction involved a gift of securities by the reporting person to the Arkadiy Dobkin GST Exempt Grantor Trust for the benefit of the reporting person's children. The reporting person's spouse is the trustee of the trust. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report should not be deemed an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
- F2These shares are held by the Arkadiy Dobkin GST Exempt Grantor Trust for the benefit of the reporting person's children. The reporting person's spouse is trustee of the trust. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report should not be deemed an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.