SEC Form 4 · accession 0001683168-18-003641
Paysign, Inc. · PAYS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Daniel Spence
Officer — Chief Technology Officer · Director · 10% Owner
Period of report
Dec 5, 2018
Accepted (ET)
Dec 7, 2018 · 4:40 pm EST
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 StockF1 | Dec 5, 2018 | A | 800,000 | — | A | 8,310,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock GrantF3,F2 | — | Dec 5, 2018 | C | 800,000 | D | — | — | Common Stock | 800,000 | 1,200,000 | D |
Explanation of responses
- F1N/A
- F2N/A
- F3On November 11 2016, the company granted Daniel Spence 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 Mr. Spence still employed by the company at that time. As of December 5th, 2018, eight hundred thousand shares have vested and have been issued. One million, two hundred thousand shares have not vested and have not been issued.