SEC Form 4 · accession 0001683168-16-000678
Paysign, Inc. · PAYS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark Newcomer
Officer — President & CEO · Director · 10% Owner
Period of report
Nov 11, 2016
Accepted (ET)
Nov 15, 2016 · 5:28 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001496443
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock GrantF2,F1 | — | Nov 11, 2016 | A | 2,000,000 | A | — | — | Common Stock | 2,000,000 | 2,000,000 | D |
Explanation of responses
- F1Not applicable.
- F2On November 11, 2016 the Company granted Mark Newcomer two million shares of common stock with a value of $315,180. The stock grant vests in equal amounts over a five year period on the last day of each calendar quarter if Mark Newcomer is still employed at that time. The shares have not been issued at this time.