0001104659-21-046137.txt : 20210402
0001104659-21-046137.hdr.sgml : 20210402
20210402165836
ACCESSION NUMBER: 0001104659-21-046137
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210331
FILED AS OF DATE: 20210402
DATE AS OF CHANGE: 20210402
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Carney Domonic J.
CENTRAL INDEX KEY: 0001390143
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37954
FILM NUMBER: 21802660
MAIL ADDRESS:
STREET 1: 9400 TOLEDO WAY
CITY: IRVINE
STATE: CA
ZIP: 92618
FORMER NAME:
FORMER CONFORMED NAME: Domonic Carney J
DATE OF NAME CHANGE: 20070215
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ShiftPixy, Inc.
CENTRAL INDEX KEY: 0001675634
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-EMPLOYMENT AGENCIES [7361]
IRS NUMBER: 474211438
STATE OF INCORPORATION: WY
FISCAL YEAR END: 0831
BUSINESS ADDRESS:
STREET 1: 1 VENTURE
STREET 2: SUITE 150
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: 888-798-9100
MAIL ADDRESS:
STREET 1: 1 VENTURE
STREET 2: SUITE 150
CITY: IRVINE
STATE: CA
ZIP: 92618
4
1
tm2111978d2_4.xml
OWNERSHIP DOCUMENT
X0306
4
2021-03-31
0
0001675634
ShiftPixy, Inc.
PIXY
0001390143
Carney Domonic J.
C/O SHIFTPIXY, INC.
501 BRICKELL KEY DRIVE, SUITE 300
MIAMI
FL
33131
0
1
0
0
Chief Financial Officer
Non-Statutory Stock Option (right to buy)
5.40
2021-03-31
4
A
0
11459
0
A
2030-07-01
Common Stock
11459
11459
D
Incentive Stock Option (right to buy)
5.40
2021-03-31
4
A
0
50000
0
A
2030-07-01
Common Stock
50000
61459
D
The option grant was approved by the board of directors of ShiftPixy, Inc. (the "Company") on July 1, 2020, subject to shareholder approval of an amendment to the ShiftPixy, Inc. 2017 Stock Option/Stock Issuance Plan (the "Plan"). The Company's shareholders approved the amendment to the Plan on March 31, 2021.
The holder's options shall become exercisable as follows: (i) 25% of the options shall become exercisable upon the holder's completion of one year of service following July 1, 2020, and (ii) the balance of the options shall become exercisable in a series of twelve successive equal quarterly installments upon the holder's completion of each additional quarter of service following July 1, 2021.
/s/ Domonic J. Carney
2021-04-02