| Accession Number: | 0001209191-23-054776 |
| Date: | 2023-11-08 |
| Issuer: | PAYMENTUS HOLDINGS, INC. (PAY) |
| Original Submission Date: |
PORTOCALIS GERASIMOS (JERRY)
11605 N. COMMUNITY HOUSE RD.
SUITE 300
CHARLOTTE, NC 28277
| Title of Security | Transaction Date | 2a. Deemed Execution Date | Transaction Code | Shares | Acquired or Disposed | Price per share | 5. Amount of Securities Beneficially Owned Following Reported Transaction | 6. Ownership Form Direct or Indirect | Nature of Indirect Ownership |
|---|---|---|---|---|---|---|---|---|---|
| CLASS A COMMON STOCK | 2023-11-08 | C | 15,000 | a | $0.00 | 454,470 | direct |
| Title of Derivative Security | Conversion or Exercise Price of Derivative Security | Transaction Date | Deemed Execution Date | Transaction Code | Number of Derivative Securities Acquired (A) or Disposed of (D) | Date Exercisable | Expiration Date | Title and Amount of Securities Underlying Derivative Security | Price of Derivative Security | Number of derivative Securities Beneficially Owned Following Reported Transaction(s) | Ownership Form: Direct (D) or Indirect (I) | Nature of Indirect Beneficial Ownership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STOCK OPTION (RIGHT TO BUY) | 8.66 | 2023-11-08 | deemed execution date | M | 15,000 (d) | 2029-08-27 | class b common stock 15,000 | $8.66 | 8,333 | direct | ||
| CLASS B COMMON STOCK | 0.0 | 2023-11-08 | deemed execution date | M | 15,000 (a) | class a common stock 15,000 | $0.00 | 15,000 | direct | |||
| CLASS B COMMON STOCK | 0.0 | 2023-11-08 | deemed execution date | C | 15,000 (d) | class a common stock 15,000 | $0.00 | 0 | direct |
| ID | footnote |
|---|---|
| f1 | represents the conversion of class b common stock into class a common stock. |
| f2 | one sixtieth (1/60th) of the shares subject to the award vested on september 30, 2019, and one sixtieth (1/60th) of the shares subject to the award vest on the last day of each month thereafter. |
| f3 | class b common stock is convertible at any time, at the holder's election and automatically in connection with certain transfers and upon certain other events, into an equal number of shares of class a common stock and has no expiration date. |
