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