SEC Form 4 · accession 0001019687-15-002556
Paysign, Inc. · PAYS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David Weiler
Director
Period of report
Jun 26, 2015
Accepted (ET)
Jun 26, 2015 · 5:09 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001496443
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF3,F1 | Jun 26, 2015 | J | 147,050 | — | D | 0 | I | Child |
| Common StockF3,F1 | Jun 26, 2015 | J | 147,050 | — | D | 0 | I | Child |
| Common Stock | holding | — | — | — | 3,248,800 | D | ||
| Common Stock | holding | — | — | — | 147,050 | I | Spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock GrantF2,F3 | — | Aug 13, 2013 | A | 500,000 | A | — | — | Common Stock | 500,000 | 500,000 | D |
Explanation of responses
- F1Reporting person's child's stock reported as indirect holdings is no longer considered as beneficially owned as children are now independent and no longer part of household.
- F2On August 13, 2013, the company granted David Weiler five hundred thousand shares of common stock with a value of $68,000. The stock grant vested in equal amounts over a five year period on the last day of each calendar quarter if David Weiler still served as a director at that time. On December 31, 2014, the board of directors waived all vesting requirements relating to the shares, and all unvested shares became fully vested as of December 31, 2014. The shares have not been issued at this time.
- F3Not applicable.