Statement of Changes in Beneficial Ownership (4)
18 December 2021 - 9:02AM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Trainor Gary |
2. Issuer Name and Ticker or Trading Symbol
Paymentus Holdings, Inc.
[
PAY
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
18390 NE 68TH ST. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/15/2021 |
(Street)
REDMOND, WA 98052
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock | 12/15/2021 | | C(1) | | 7350 | A | $0.00 | 7350 | I | See Explanation of Responses (2) |
Class A Common Stock | 12/15/2021 | | S(3) | | 7350 | D | $27.49 (4) | 0 | I | See Explanation of Responses (2) |
Class A Common Stock | 12/16/2021 | | C(1) | | 6867 | A | $0.00 | 6867 | I | See Explanation of Responses (2) |
Class A Common Stock | 12/16/2021 | | S(3) | | 6867 | D | $27.27 (5) | 0 | I | See Explanation of Responses (2) |
Class A Common Stock | 12/16/2021 | | C(1) | | 483 | A | $0.00 | 483 | I | See Explanation of Responses (2) |
Class A Common Stock | 12/16/2021 | | S(3) | | 483 | D | $28.03 (6) | 0 | I | See Explanation of Responses (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (Right to Buy) | $0.03 | 12/15/2021 | | M | | | 7350 | (7) | 10/10/2022 | Class B Common Stock (8) | 7350 | $0.00 | 1382165 | I | See Explanation of Responses (2) |
Class B Common Stock | (8) | 12/15/2021 | | M | | 7350 | | (8) | (8) | Class A Common Stock | 7350 | $0.00 | 7350 | I | See Explanation of Responses (2) |
Class B Common Stock | (8) | 12/15/2021 | | C | | | 7350 | (8) | (8) | Class A Common Stock | 7350 | $0.00 | 0 | I | See Explanation of Responses (2) |
Stock Option (Right to Buy) | $0.03 | 12/16/2021 | | M | | | 7350 | (7) | 10/10/2022 | Class B Common Stock (8) | 7350 | $0.00 | 1374815 | I | See Explanation of Responses (2) |
Class B Common Stock | (8) | 12/16/2021 | | M | | 7350 | | (8) | (8) | Class A Common Stock | 7350 | $0.00 | 7350 | I | See Explanation of Responses (2) |
Class B Common Stock | (8) | 12/16/2021 | | C | | | 7350 | (8) | (8) | Class A Common Stock | 7350 | $0.00 | 0 | I | See Explanation of Responses (2) |
Explanation of Responses: |
(1) | Represents the conversion of Class B Common Stock into Class A Common Stock held of record by TF Investment Holdings LLC. |
(2) | Represents shares held directly by TF Investment Holdings LLC. Gary Trainor is the sole manager of TF Investment Holdings LLC and has sole voting and dispositive power with respect to the shares held by TF Investment Holdings LLC. |
(3) | The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by TF Investment Holdings LLC on September 15, 2021. |
(4) | The "Amount" and "Price" reported in this Column 4 reflect the aggregate number and weighted-average price, respectively, of shares sold. These shares were sold in multiple transactions at prices ranging from $27.11 to $28.00, inclusive. The reporting person undertakes to provide to Paymentus Holdings, Inc., any security holder of Paymentus Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth herein. |
(5) | The "Amount" and "Price" reported in this Column 4 reflect the aggregate number and weighted-average price, respectively, of shares sold. These shares were sold in multiple transactions at prices ranging from $26.94 to $27.89, inclusive. The reporting person undertakes to provide to Paymentus Holdings, Inc., any security holder of Paymentus Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth herein. |
(6) | The "Amount" and "Price" reported in this Column 4 reflect the aggregate number and weighted-average price, respectively, of shares sold. These shares were sold in multiple transactions at prices ranging from $27.98 to $28.16, inclusive. The reporting person undertakes to provide to Paymentus Holdings, Inc., any security holder of Paymentus Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth herein. |
(7) | The shares subject to the option are fully vested and exercisable. |
(8) | Class B Common Stock is convertible at any time, at the holder's election and automatically in connection with certain transfers and upon certain other events, into an equal number of shares of Class A Common Stock and has no expiration date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Trainor Gary 18390 NE 68TH ST. REDMOND, WA 98052 | X |
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Signatures
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/s/ Matt Parson, Attorney-in-Fact | | 12/17/2021 |
**Signature of Reporting Person | Date |
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