0001140361-21-032342.txt : 20210923 0001140361-21-032342.hdr.sgml : 20210923 20210923203043 ACCESSION NUMBER: 0001140361-21-032342 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210921 FILED AS OF DATE: 20210923 DATE AS OF CHANGE: 20210923 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dubin Lane CENTRAL INDEX KEY: 0001683495 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37584 FILM NUMBER: 211273732 MAIL ADDRESS: STREET 1: C/O CPI CARD GROUP INC. STREET 2: 10368 WEST CENTENNIAL RD. CITY: LITTLETON STATE: IL ZIP: 80127 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 RD CITY: LITTLETON STATE: CO ZIP: 80127 BUSINESS PHONE: 720-681-6304 MAIL ADDRESS: STREET 1: 10368 WEST CENTENNIAL RD CITY: LITTLETON STATE: CO ZIP: 80127 FORMER COMPANY: FORMER CONFORMED NAME: CPI Holdings I, Inc. DATE OF NAME CHANGE: 20150506 4 1 form4.xml FORM 4 X0306 4 2021-09-21 0001641614 CPI Card Group Inc. PMTS 0001683495 Dubin Lane C/O CPI CARD GROUP INC. 10368 W. CENTENNIAL ROAD LITTLETON CO 80127 true SVP & GM of Pers., Ppd. & Iss. Restricted Stock Units 2021-09-21 4 A 0 5270 0 A Common Stock 5270 5270 D Stock Option (Right to Buy) 29.62 2021-09-21 4 A 0 8932 0 A 2028-09-21 Common Stock 8932 8932 D Each restricted stock unit ("RSU") represents the right to receive one common share of Issuer upon vesting of such RSU. 50% of the RSUs reported on this line vest on the first anniversary of the September 21, 2021 award date and 50% vest on the second anniversary of the award date, subject to the reporting person's continued service through such date or as otherwise provided for in the applicable award agreement. 50% of the options reported on this line vest on the first anniversary of the September 21, 2021 award date and 50% vest on the second anniversary of the award date, subject to the reporting person's continued service through such date or as otherwise provided for in the applicable award agreement. /s/ Sarah Kilgore, attorney-in-fact 2021-09-23