SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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* Ronaldi Jeffrey (Last) (First) (Middle) C/O DOCUMENT SECURITY SYSTEMS, INC. 28 EAST MAIN STREET, SUITE 1525 (Street) ROCHESTER NY 14614 (City) (State) (Zip)	2. Date of Event Requiring Statement (Month/Day/Year) 07/01/2013	3. Issuer Name and Ticker or Trading Symbol DOCUMENT SECURITY SYSTEMS INC [ DSS ]
		4. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner X Officer (give title below) Other (specify below) Chief Executive Officer	5. If Amendment, Date of Original Filed (Month/Day/Year)
			6. Individual or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting Person Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, par value $0.02 per share	74,708(1)	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Warrants	07/01/2013	07/02/2018	Common Stock	13,402	$4.8	D
Stock Options	(2)	11/20/2022	Common Stock	1,000,000	$3	D

Explanation of Responses:

1. Of the shares of common stock reported, 19,580 shares are held in escrow by American Stock Transfer & Trust Company, LLC. These shares will be released to the Reporting Person if and when the closing price per share of the Issuer's common stock exceeds $5.00 per share (as adjusted for stock splits, stock dividends and similar events) for 40 trading days within a continuous 90 day trading period following July 1, 2013. If prior to July 1, 2014, such threshold is not achieved, these shares will be canceled and extinguished.

2. One half of these options shall vest in 12 equal quarterly tranches, with the first tranches having vested as of November 15, 2012, February 15, 2013, and May 15, 2013 and the remaining tranches vesting on each of August 15, November 15, February 15 and May 15 thereafter through August 15, 2015. Following the completion of the Merger on July 1, 2013, the remaining one half of these options shall vest in 12 equal tranches, with a tranche to vest on the last day of each calendar quarter commencing on September 30, 2013.

Remarks:

Exhibit List - Exhibit 24 - Power of Attorney

	/s/ Ilan Goldbard, attorney in fact for Jeffrey Ronaldi	07/08/2013
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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