SEC Form 4 · accession 0001104659-17-055796
CPI Card Group Inc. · PMTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lane Dubin
Officer — SVP, Sales & Marketing
Period of report
Sep 1, 2017
Accepted (ET)
Sep 6, 2017 · 4:09 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001641614
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Sep 1, 2017 | M | 4,641 | — | A | 4,641 | D | |
| Common Stock | Sep 1, 2017 | F | 1,462 | $0.96 | D | 3,179 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF4,F1,F3 | — | Sep 1, 2017 | M | 4,641 | D | — | — | Common Stock | 4,641 | 23,073 | D |
Explanation of responses
- F1Each restricted stock unit represents the right to receive one CPI Card Group Inc. common share upon vesting of such restricted stock unit.
- F2Shares withheld by the issuer to satisfy the mandatory tax withholding requirement upon vesting of restricted stock. This is not an open market sale of securities.
- F3On September 1, 2016, the reporting person was granted 18,562 restricted stock units, vesting in four equal installments on the first, second, third and fourth anniversaries of the award date.
- F4Total includes additional restricted stock unit awards that have different vesting and expiration dates.