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DSS, INC. Director's Dealing 2017

Dec 15, 2017

35136_dirs_2017-12-15_ca36e820-079c-435d-bab6-8c0de5ad2a59.zip

Director's Dealing

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SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: DOCUMENT SECURITY SYSTEMS INC (DSS)
CIK: 0000771999
Period of Report: 2017-12-13

Reporting Person: Chan Heng Fai Ambrose (Director, 10% Owner)

Non-Derivative Transactions

Date Security Code Shares Price A/D Holdings After Ownership
2017-12-13 Common Stock X 160000 $1 Acquired 960000 Indirect

Derivative Transactions

Date Security Exercise Price Code Shares A/D Expiration Underlying Ownership
2017-12-13 Warrant to Purchase Common Stock $1 X 160000 Disposed 2022-09-08 Common Stock (160000) Indirect

Holdings (Non-Derivative)

Security Shares Ownership
Common Stock 500000 Indirect
Common Stock 683000 Indirect
Common Stock 2912 Direct

Footnotes

F1: Held by Heng Fai Holdings Limited, of which Reporting Person is an Officer and the owner. The Reporting Person has dispositive control over these securities.

F2: Held by BMI Capital Partners International Limited, of which the Reporting Person is a director. The Reporting Person has dispositive control over these securities.

F3: Held by Hengfai Business Development Pte Ltd., of which the Reporting Person is the Chief Executive Officer and owner. The Reporting Person has dispositive control over these securities.