SEC Form 4 · accession 0001104659-18-020190
CPI Card Group Inc. · PMTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Anna Rossetti
Officer — President-CPI Canada
Period of report
Mar 22, 2018
Accepted (ET)
Mar 26, 2018 · 7:48 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 Stock | Mar 22, 2018 | M | 13,434 | $0.00 | A | 29,632 | D | |
| Common StockF1 | Mar 22, 2018 | D | 13,434 | $0.50 | D | 16,198 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cash Performance UnitsF2 | — | Mar 22, 2018 | M | 13,434 | D | — | — | Common Stock | 13,434 | 26,787 | D |
Explanation of responses
- F1This disposition to the issuer reflects the settlement of approximately 1/3 of the performance units in cash.
- F2Each performance unit vested on March 22, 2018 and entitled the reporting person to receive a cash payment equal to the target value of $1.00 per unit, subject to adjustment based on the issuer's stock price performance.
Remarks
Shares of Common Stock reflected in this Form 4 give effect to the one-for-five reverse stock split effected on December 20, 2017.