0000904454-16-001350.txt : 20160803 0000904454-16-001350.hdr.sgml : 20160803 20160803170443 ACCESSION NUMBER: 0000904454-16-001350 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160801 FILED AS OF DATE: 20160803 DATE AS OF CHANGE: 20160803 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Paycom Software, Inc. CENTRAL INDEX KEY: 0001590955 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 800957485 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 BUSINESS PHONE: (405) 722-6900 MAIL ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SWANI SANJAY CENTRAL INDEX KEY: 0001212996 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36393 FILM NUMBER: 161804688 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2016-08-01 1 0001590955 Paycom Software, Inc. PAYC 0001212996 SWANI SANJAY C/O WELSH, CARSON, ANDERSON AND STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 1 0 0 1 Resigned 08/01/2016 Common Stock 2016-08-01 4 D 0 1283 0 D 178976 D Shares forfeited under a Restricted Stock Award Agreement pursuant to the Issuer's 2014 Long-Term Incentive Plan, as a result of the Reporting Person's resignation from the Issuer's Board of Directors. The Reporting Person also indirectly beneficially owns 63,934 shares held by The Swani Family LLC. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. /s/David Mintz, Attorney-in-Fact 2016-08-03