SEC Form 5 · accession 0000904454-16-000976
Paycom Software, Inc. · PAYC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sanjay Swani
Director · Other
Period of report
Dec 31, 2015
Accepted (ET)
Feb 12, 2016 · 10:53 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001590955
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | May 27, 2015 | G | 7,500 | $0.00 | D | 213,536 | D | |
| Common StockF1,F2 | Oct 13, 2015 | G | 85,750 | $0.00 | D | 127,786 | D | |
| Common StockF1,F2 | Dec 16, 2015 | G | 15,000 | $0.00 | D | 112,786 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The Reporting Person also indirectly beneficially owns 5,065,436 shares of Common Stock held by Welsh, Carson, Anderson & Stowe X, L.P. and 53,828 shares of Common Stock held by WCAS Capital Partners IV, L.P. The Reporting Person is a managing member of the respective sole general partners of Welsh, Carson, Anderson & Stowe X, L.P. and WCAS Capital Partners IV, L.P. Pursuant to Instruction (4)(b)(iv) of Form 5, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.
- F2The Reporting Person also indirectly beneficially owns 50,314 shares of Common Stock held by the Swani Family LLC. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.