Form 4 for PAYS Paysign, Inc.
Accepted 2021-10-04 00:00:00 ET · period of report 2021-09-30 · accession 0001683168-21-004686 · SEC index · Original document
Summary rows
Aggregated the way they appear in lists: one row per insider, transaction code and security table.
| X | Filed | Traded | Ticker | Insider | Title | Type | Price | Qty | Owned | ΔOwn | Value |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DM | 2021-10-04 | 2021-10-01+ | PAYS | Newcomer Mark | CEO, Dir, 10% | S - Sale+OE | $153.40 | -41.3K | 9.38M | -0.4% | -$6.33M |
| D | 2021-10-04 | 2021-09-30 | PAYS | Newcomer Mark | CEO, Dir, 10% | M - OptEx | $2.70 | +100.0K | 9.42M | +1% | +$270.0K |
| D | 2021-10-04 | 2021-09-30 | PAYS | Newcomer Mark | CEO, Dir, 10% | M - OptEx | — | -100.0K | 0 | -100% | — |
Purchase Sale Sale after option exercise All abbreviations
Every reported transaction
| # | Table | Security | Date | Code | A/D | Shares | Price | Owned after | Own | Exercise / expiry | Underlying | Footnotes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Common | Common Stock | 2021-10-01 | S | D | 38,828 | $2.58 | 9,383,664 | D | — | — | (F3) The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $2.48 to $2.62, inclusive. The reporting person undertakes to provide to Paysign, Inc. (the "Company"), any security holder of the Company, or the staff of the Securities and Exchange Commission (the "SEC"), upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 2 | Common | Common Stock | 2021-10-04 | S | D | 2,462 | $2,532.00 | 9,381,202 | D | — | — | (F4) The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $2.51 to $2.57, inclusive. The reporting person undertakes to provide to the Company, any security holder of the Company, or the staff of the SEC, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. |
| 3 | Common | Common Stock | 2021-09-30 | M | A | 100,000 | $2.70 | 9,422,492 | D | — | — | |
| 4 | Derivative | Stock Grant | 2021-09-30 | M | D | 100,000 | — | 0 | D | — · — to — | 100,000 Common Stock | (F1) On November 11, 2016, the reporting person received a grant of 2,000,000 shares of common stock vesting in equal amounts over a 5 year period on the last day of each quarter if employed by the company at that time. As of the date of this filing, 2,000,000 shares of common stock have vested and been issued. |