DSS, INC. — Director's Dealing 2016

Oct 4, 2016

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: DOCUMENT SECURITY SYSTEMS INC (DSS)
CIK: 0000771999
Period of Report: 2016-09-29

Reporting Person: FAGENSON ROBERT B (Director)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2016-09-29	Common Stock	P	1874	$0.63	Acquired	293931	Direct

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock	50000	Indirect

Footnotes

F1: Amounts reflect a 1-for-4 reverse stock split which was affected by DSS on August 26, 2016.

F2: Consists of 25,000 shares held by Mr. Fagenson's wife, and an aggregate of 25,000 shares held in trusts for Mr. Fagenson's two adult children, of which Mr. Fagenson is trustee. Mr. Fagenson disclaims beneficial ownership of these 50,000 shares.