DSS, INC. — Director's Dealing 2013

Jul 8, 2013

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: DOCUMENT SECURITY SYSTEMS INC (DSS)
CIK: 0000771999
Period of Report: 2013-07-01

Reporting Person: Ronaldi Jeffrey (Director, Chief Executive Officer)

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock, par value $0.02 per share	74708	Direct

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Warrants	$4.80	2018-07-02	Common Stock (13402)		Direct
Stock Options	$3.00	2022-11-20	Common Stock (1000000)		Direct

Footnotes

F1: Of the shares of common stock reported, 19,580 shares are held in escrow by American Stock Transfer & Trust Company, LLC. These shares will be released to the Reporting Person if and when the closing price per share of the Issuer's common stock exceeds $5.00 per share (as adjusted for stock splits, stock dividends and similar events) for 40 trading days within a continuous 90 day trading period following July 1, 2013. If prior to July 1, 2014, such threshold is not achieved, these shares will be canceled and extinguished.

F2: One half of these options shall vest in 12 equal quarterly tranches, with the first tranches having vested as of November 15, 2012, February 15, 2013, and May 15, 2013 and the remaining tranches vesting on each of August 15, November 15, February 15 and May 15 thereafter through August 15, 2015. Following the completion of the Merger on July 1, 2013, the remaining one half of these options shall vest in 12 equal tranches, with a tranche to vest on the last day of each calendar quarter commencing on September 30, 2013.