0001213900-22-013672.txt : 20220318 0001213900-22-013672.hdr.sgml : 20220318 20220318192543 ACCESSION NUMBER: 0001213900-22-013672 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220316 FILED AS OF DATE: 20220318 DATE AS OF CHANGE: 20220318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DOSTER MELINDA CENTRAL INDEX KEY: 0001855008 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39627 FILM NUMBER: 22753899 MAIL ADDRESS: STREET 1: 303 PERIMETER CENTER NORTH, SUITE 600 CITY: ATLANTA STATE: GA ZIP: 30346 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Paya Holdings Inc. CENTRAL INDEX KEY: 0001819881 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 852199433 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 303 PERIMETER CENTER NORTH STREET 2: SUITE 600 CITY: ATLANTA STATE: GA ZIP: 30346 BUSINESS PHONE: (800) 261-0240 MAIL ADDRESS: STREET 1: 303 PERIMETER CENTER NORTH STREET 2: SUITE 600 CITY: ATLANTA STATE: GA ZIP: 30346 FORMER COMPANY: FORMER CONFORMED NAME: FINTECH ACQUISITION CORP III PARENT CORP DATE OF NAME CHANGE: 20200731 4 1 ownership.xml X0306 4 2022-03-16 0 0001819881 Paya Holdings Inc. PAYA 0001855008 DOSTER MELINDA 303 PERIMETER CENTER NORTH SUITE 600 ATLANTA GA 30346 0 1 0 0 GENERAL COUNSEL Common Stock 2022-03-16 4 A 0 18677 0.00 A 54051 D Option (Right to Buy) 5.12 2022-03-16 4 A 0 56031 0.00 A 2032-03-16 Common Stock 56031 56031 D Consists of restricted stock units which vest in three equal annual installments on March 16, 2023, March 16, 2024 and March 16, 2025. The option vests and becomes exercisable in five equal annual installments on March 16, 2023, March 16, 2024, March 16, 2025, March 16, 2026 and March 16, 2027. /s/ Glenn Renzulli, by Power of Attorney 2022-03-18