0000899243-17-003913.txt : 20170214 0000899243-17-003913.hdr.sgml : 20170214 20170214091431 ACCESSION NUMBER: 0000899243-17-003913 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161231 FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 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: Richison Chad R. CENTRAL INDEX KEY: 0001594487 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36393 FILM NUMBER: 17602943 MAIL ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2016-12-31 0 0 0 0001590955 Paycom Software, Inc. PAYC 0001594487 Richison Chad R. 7501 W. MEMORIAL ROAD OKLAHOMA CITY OK 73142 1 1 1 0 President and CEO Common Stock 2016-12-21 5 G 0 2295 0.00 D 4073925 D Common Stock 3670999 I By Ernest Group, Inc. Common Stock 229135 I By The Ruby Group, Inc. Includes 529,055 unvested shares of restricted stock. Represents shares of common stock owned by Ernest Group, Inc. ("Ernest Group"). The reporting person is the sole director of Ernest Group and Ernest Group is owned by the reporting person and certain trusts for the benefit of the reporting person's children, for which the reporting person serves as trustee. The reporting person may be deemed to beneficially own the shares of common stock owned by Ernest Group. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein. Neither the filing of this report nor anything herein shall be deemed an admission that the reporting person is, for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose, the beneficial owner of such securities. Represents shares of common stock owned by The Ruby Group, Inc. ("Ruby Group"). The reporting person is the sole director and sole shareholder of Ruby Group and may be deemed to beneficially own the shares of common stock owned by Ruby Group. /s/ Chad R. Richison 2017-02-08