0000904454-16-000970.txt : 20160212 0000904454-16-000970.hdr.sgml : 20160212 20160212104109 ACCESSION NUMBER: 0000904454-16-000970 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160212 DATE AS OF CHANGE: 20160212 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: DENICOLA ANTHONY J CENTRAL INDEX KEY: 0001212992 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36393 FILM NUMBER: 161415904 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 5 1 edgar.xml PRIMARY DOCUMENT X0306 5 2015-12-31 1 0 0 0001590955 Paycom Software, Inc. PAYC 0001212992 DENICOLA ANTHONY J C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 0 1 Former 10% Owner Common Stock 2015-08-10 5 G 0 130000 0 D 313410 D Common Stock 2015-11-04 5 G 0 125000 0 D 188410 D The Reporting Person also indirectly beneficially owns 5,065,436 shares of Common Stock held by Welsh, Carson, Anderson & Stowe X, L.P. and 53,828 shares of Common Stock held by WCAS Capital Partners IV, L.P. 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. Pursuant to Instruction (4)(b)(iv) of Form 5, 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 also indirectly beneficially owns 71,877 shares of Common Stock held by deNicola Holdings II LLC. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. Shares beneficially owned as of 11/18/2015, after which the Reporting Person ceased to be a 10% Owner of the Common Stock. /s/David Mintz, Attorney-in-Fact 2016-02-12