0001104659-15-070147.txt : 20151009 0001104659-15-070147.hdr.sgml : 20151009 20151009165605 ACCESSION NUMBER: 0001104659-15-070147 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151008 FILED AS OF DATE: 20151009 DATE AS OF CHANGE: 20151009 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CPI Card Group Inc. CENTRAL INDEX KEY: 0001641614 STANDARD INDUSTRIAL CLASSIFICATION: SHORT-TERM BUSINESS CREDIT INSTITUTIONS [6153] IRS NUMBER: 260344657 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10368 WEST CENTENNIAL ROAD CITY: LITTLETON STATE: CO ZIP: 80127 BUSINESS PHONE: 303-973-9311 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL ROAD CITY: LITTLETON STATE: CO ZIP: 80127 FORMER COMPANY: FORMER CONFORMED NAME: CPI Holdings I, Inc. DATE OF NAME CHANGE: 20150506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dreiling Jerry CENTRAL INDEX KEY: 0001654521 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37584 FILM NUMBER: 151153652 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL RD. CITY: LITTLETON STATE: CO ZIP: 80127 4 1 a4.xml 4 X0306 4 2015-10-08 0 0001641614 CPI Card Group Inc. PMTS 0001654521 Dreiling Jerry C/O CPI CARD GROUP INC. 10368 WEST CENTENNIAL ROAD LITTLETON CO 80127 0 1 0 0 VP & Chief Accounting Officer Common Stock 364188 D Stock Option (Right to Buy) 10.00 2015-10-08 4 A 0 25000 0 A 2017-10-08 2025-10-08 Common Stock 25000 25000 D Date at which first vesting occurs is indicated. Subject to the insider's continued employment, approximately one third (1/3) of the original options granted will vest on each of the second, third and fourth anniversaries of the October 8, 2015 grant date. /s/ Lisa Jacoba, by Power of Attorney 2015-10-09