0001521536-13-000581.txt : 20130702 0001521536-13-000581.hdr.sgml : 20130702 20130702080154 ACCESSION NUMBER: 0001521536-13-000581 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20130702 DATE AS OF CHANGE: 20130702 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: DOCUMENT SECURITY SYSTEMS INC CENTRAL INDEX KEY: 0000771999 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 161229730 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-50256 FILM NUMBER: 13946443 BUSINESS ADDRESS: STREET 1: 36 WEST MAIN ST STREET 2: SUITE 710 CITY: ROCHESTER STATE: NY ZIP: 14614 BUSINESS PHONE: 585 232 1500 MAIL ADDRESS: STREET 1: 36 W MAIN ST STREET 2: SUITE 710 CITY: ROCHESTER STATE: NY ZIP: 14614 FORMER COMPANY: FORMER CONFORMED NAME: NEW SKY COMMUNICATIONS INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: THOROUGHBREDS USA INC DATE OF NAME CHANGE: 19861118 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Honig Barry C CENTRAL INDEX KEY: 0001373203 FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: 595 S FEDERAL HIGHWAY STREET 2: SUITE 600 CITY: BOCA RATON STATE: FL ZIP: 33432 FORMER COMPANY: FORMER CONFORMED NAME: Honig Barry R DATE OF NAME CHANGE: 20060818 SC 13G 1 q1101167_bhonig13g-dss.htm Unassociated Document
 
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549

SCHEDULE 13G
(Rule 13d-102)

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO RULE 13d-1(b) (c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO
RULE 13d-2(b)


DOCUMENT SECURITY SYSTEMS, INC.
(Name of Issuer)

COMMON STOCK, PAR VALUE $0.02 PER SHARE
(Title of Class of Securities)

25614T101
(CUSIP Number)

 
July 1, 2013
(Date of Event Which Requires Filing of This Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

[   ] Rule 13d-1(b)
[ x] Rule 13d-1(c)
[   ] Rule 13d-1(d)

1
 
 
 
 
 
CUSIP No. 25614T101
 
 
1
 
NAME OF REPORTING PERSONS
S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
 
Barry Honig
 
2
 
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
 
(a) ¨
(b) ¨
 
3
 
SEC USE ONLY
 
 
4
 
CITIZENSHIP OR PLACE OF ORGANIZATION
 
United States
 
 
 
NUMBER OF SHARES
 
5
 
SOLE VOTING POWER
 
502,786
 
BENEFICIALLY
OWNED BY
 
6
 
SHARED VOTING POWER
 
2,100,759(1)
 
EACH
REPORTING
 
7
 
SOLE DISPOSITIVE POWER
 
502,786
 
PERSON WITH
 
8
 
SHARED DISPOSITIVE POWER
 
2,100,759 (1)
 
9
 
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
2,603,545 (1)
 
10
 
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
11
 
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
 
5.74% (1)(2)
 
12
 
TYPE OF REPORTING PERSON*
 
IN
 
(1)
Includes 782,912 shares of common stock held by GRQ Consultants, Inc. 401K Plan (“GRQ 401K Plan”) and 1,317,847 shares of common stock held by GRQ Consultants, Inc. Roth 401K FBO Barry Honig (“GRQ Roth 401K Plan”). Mr. Honig is the trustee of GRQ 401K Plan and GRQ Roth 401K Plan and is deemed to hold voting and dispositive power over shares held by such entities.
 
(2) 
Based on 45,367,875 shares outstanding as of July 1, 2013.
  
 
 
2
 
 
CUSIP No. 25614T101
 
 
1
 
NAME OF REPORTING PERSONS
S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
 
GRQ Consultants, Inc. 401K Plan
 
2
 
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
 
(a) ¨
(b) ¨
 
3
 
SEC USE ONLY
 
 
4
 
CITIZENSHIP OR PLACE OF ORGANIZATION
 
Florida
 
 
NUMBER OF SHARES
 
5
 
SOLE VOTING POWER
 
0
 
BENEFICIALLY
OWNED BY
 
6
 
SHARED VOTING POWER
 
782,912
 
EACH
REPORTING
 
7
 
SOLE DISPOSITIVE POWER
 
0
 
PERSON WITH
 
8
 
SHARED DISPOSITIVE POWER
 
782,912
 
9
 
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
782,912
 
10
 
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
11
 
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
 
1.73% (1)
 
12
 
TYPE OF REPORTING PERSON*
 
OO
 
(1)           Based on 45,367,875 shares outstanding as of July 1, 2013.
 
 
3
 
 
CUSIP No. 25614T101
 
 
1
 
NAME OF REPORTING PERSONS
S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
 
GRQ Consultants, Inc. Roth 401K FBO Barry Honig
 
2
 
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
 
(a) ¨
(b) ¨
 
3
 
SEC USE ONLY
 
 
4
 
CITIZENSHIP OR PLACE OF ORGANIZATION
 
Florida
 
 
NUMBER OF SHARES
 
5
 
SOLE VOTING POWER
 
0
 
BENEFICIALLY
OWNED BY
 
6
 
SHARED VOTING POWER
 
1,317,847
 
EACH
REPORTING
 
7
 
SOLE DISPOSITIVE POWER
 
0
 
PERSON WITH
 
8
 
SHARED DISPOSITIVE POWER
 
1,317,847
 
9
 
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
1,317,847
 
10
 
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
11
 
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
 
2.90% (1)
 
12
 
TYPE OF REPORTING PERSON*
 
OO
 
(1)           Based on 45,367,875 shares outstanding as of July 1, 2013.
 
 
4
 
 
Item1(a).
Name of Issuer:
 
Document Security Systems, Inc.
 
Item1(b).
Address of Issuer's Principal Executive Offices:
 
First Federal Plaza, Suite 1525, 28 East Main Street, Rochester, NY 14614
    
 
Item 2(a).
Name of Person Filing.
 
The statement is filed on behalf of Barry Honig, GRQ Consultants, Inc. 401K Plan (“GRQ 401K Plan”) and GRQ Consultants, Inc. Roth 401K FBO Barry Honig (“GRQ Roth 401K Plan”).
 
Item 2(b).
Address of Principal Business Office or, if None, Residence.
 
555 South Federal Highway #450, Boca Raton, FL 33432
 
Item 2(c).
Citizenship.
 
United States/Florida
 
Item 2(d).
Title of Class of Securities.
 
Common Stock, par value $0.02 per share
 
Item 2(e).
CUSIP Number.
 
25614T101
 
Item 3.
Type of Person
 
Not applicable.
 
Item 4.
Ownership.
 
(a) Amount beneficially owned: 2,603,545 (1).

(b) Percent of class: 5.74% (1)(2).

(c) Number of shares as to which the person has:

(i) Sole power to vote or to direct the vote: 502,786.

(ii) Shared power to vote or to direct the vote: 2,100,759 (1).

(iii) Sole power to dispose or to direct the disposition of: 502,786.

(iv) Shared power to dispose or to direct the disposition of: 2,100,759 (1).
 
Item 5.
Ownership of Five Percent or Less of a Class.

Not applicable.
 
Item 6.
Ownership of More than Five Percent on Behalf of Another Person.

Not Applicable
 
 
(1)
Includes 782,912 shares of common stock held by GRQ 401K Plan and 1,317,847 shares of common stock held by GRQ Roth 401K Plan. Mr. Honig is the trustee of GRQ 401K Plan and GRQ Roth 401K Plan and is deemed to hold voting and dispositive power over shares held by such entities.
 
(2)
Based on 45,367,875 shares outstanding as of July 1, 2013.
 
 
 
5
 
 
Item 7.
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported by the Parent Holding Company.
 
Not applicable.
 
Item 8.
Identification and Classification of Members of the Group.

Not applicable.
 
Item 9.
Notice of Dissolution of Group.

Not applicable.
 
Item 10.
Certifications.
 
By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.
 
 
 
6
 
 
SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Date: July 2, 2013
By: 
/s/ Barry Honig
  
   
Barry Honig
  
       
   
GRQ Consultants, Inc. 401K Plan
  
Date: July 2, 2013
By: 
/s/ Barry Honig
  
   
Barry Honig
  
       
   
GRQ Consultants, Inc. Roth 401K FBO Barry Honig
  
Date: July 2, 2013
By: 
/s/ Barry Honig
  
   
Barry Honig