0000899243-22-005276.txt : 20220208 0000899243-22-005276.hdr.sgml : 20220208 20220208190024 ACCESSION NUMBER: 0000899243-22-005276 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220208 DATE AS OF CHANGE: 20220208 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: 22603300 MAIL ADDRESS: STREET 1: 7501 W. MEMORIAL ROAD CITY: OKLAHOMA CITY STATE: OK ZIP: 73142 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 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2021-12-31 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 2021-12-14 5 G 0 420 0.00 D 4737055 D Common Stock 2021-12-14 5 G 0 35 0.00 A 125 I By Ava L. Richison 2012 Irrevocable Trust U/T/A DTD 12/21/2012 Common Stock 2021-12-14 5 G 0 35 0.00 A 125 I By Ian D. Richison 2012 Irrevocable Trust U/T/A DTD 12/21/2012 Common Stock 3670999 I By Ernest Group, Inc. Common Stock 56 I By Abrie R.Richison 2012 Irrevocable Trust U/T/A DTD 12/21/2012 Includes 1,631,000 unvested shares of restricted stock. Represents shares received pursuant to a gift from the reporting person. Represents shares of common stock owned by the Ava L. Richison 2012 Irrevocable Trust U/T/A DTD 12/21/2012 (the "Ava L. Richison 2012 Irrevocable Trust"). The reporting person is the settlor and sole trustee for the Ava L. Richison 2012 Irrevocable Trust, which is for the benefit of the reporting person's child. The reporting person may be deemed to beneficially own the shares of common stock owned by the Ava L. Richison 2012 Irrevocable Trust. Represents shares of common stock owned by the Ian D. Richison 2012 Irrevocable Trust U/T/A DTD 12/21/2012 (the "Ian D. Richison 2012 Irrevocable Trust"). The reporting person is the settlor and sole trustee for the Ian D. Richison 2012 Irrevocable Trust, which is for the benefit of the reporting person's child. The reporting person may be deemed to beneficially own the shares of common stock owned by the Ian D. Richison 2012 Irrevocable Trust. 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 wholly owned by the reporting person and certain trusts for 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. Represents shares of common stock owned by the Abrie R. Richison 2012 Irrevocable Trust U/T/A DTD 12/21/2012 (the "Abrie R. Richison 2012 Irrevocable Trust"). The reporting person is the settlor and sole trustee for the Abrie R. Richison 2012 Irrevocable Trust, which is for the benefit of the reporting person's child. The reporting person may be deemed to beneficially own the shares of common stock owned by the Abrie R. Richison 2012 Irrevocable Trust. /s/ Chad R. Richison 2022-02-07