SEC Form 4 · accession 0001104659-17-059301
CPI Card Group Inc. · PMTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Scott Scheirman
Director
Period of report
Sep 25, 2017
Accepted (ET)
Sep 27, 2017 · 9:43 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001641614
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 Option (Right to Buy)F1,F2,F3 | $1.05 | Sep 25, 2017 | A | 1,400,000 | A | Sep 25, 2018 | Sep 25, 2027 | Common Stock | 1,400,000 | 1,400,000 | D |
Explanation of responses
- F1Granted in connection with Mr. Scheirman's employment with the Company. Mr. Scheirman will assume the role of Chief Executive Officer of the Company effective October 5, 2017.
- F2The grant of 619,467 options is contingent upon receipt and effectiveness of approval by the Company's stockholders of an amendment to the CPI Card Group Inc. Omnibus Incentive Plan to, among other things, increase the number of shares available for issuance thereunder.
- F3Date at which first vesting occurs is indicated. One-third (1/3) of the original options awarded will vest on each of the first, second and third anniversaries of the September 25, 2017 award date.