0000904454-15-000360.txt : 20150522 0000904454-15-000360.hdr.sgml : 20150522 20150522123740 ACCESSION NUMBER: 0000904454-15-000360 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150520 FILED AS OF DATE: 20150522 DATE AS OF CHANGE: 20150522 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: RATHER JONATHAN M CENTRAL INDEX KEY: 0001212994 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36393 FILM NUMBER: 15885599 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2015-05-20 0001590955 Paycom Software, Inc. PAYC 0001212994 RATHER JONATHAN M C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 Common Stock 2015-05-20 4 S 0 5096287 35.75 D 11882740 I By Welsh, Carson, Anderson & Stowe X, L.P. Common Stock 2015-05-20 4 S 0 54154 35.75 D 126271 I By WCAS Capital Partners IV, L.P. Common Stock 134998 D Common Stock 30548 I By JMR4 Holdings LLC Common Stock 72795 I By WCAS Management Corporation The Reporting Person is a managing member of the respective sole general partners of Welsh, Carson, Anderson & Stowe X, L.P. and WCAS Capital Partners IV, L.P, and the controlling stockholder of WCAS Management Corporation. Pursuant to Instruction (4)(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest, if any, therein. /s/David Mintz, Attorney-in-Fact 2015-05-22