DSS, INC. — Major Shareholding Notification 2018

Jul 6, 2018

SC 13D/A 1 formsc13da.htm

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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549

SCHEDULE 13D

Under the Securities Exchange Act of 1934

(Amendment No. 1)

| DOCUMENT
SECURITY SYSTEMS, INC. |
| --- |
| (Name
of Issuer) |

| Common
Stock, par value $0.02 per share |
| --- |
| (Title
of Class of Securities) |

25614T200
(CUSIP
Number)

| Jeffrey
D’Angelo, Vice President, General Counsel Document
Security Systems, Inc. 200
Canal View Blvd., Suite 300 Rochester,
New York 14623 with
copy to: Alexander
M. Donaldson Wyrick
Robbins Yates & Ponton LLP 4101
Lake Boone Trail, Suite 300 Raleigh,
North Carolina 27607 Telephone:
(919) 781-4000 |
| --- |
| (Name,
Address and Telephone Number of Person Authorized to Receive Notices and Communications) |
| July
3, 2018 |
| (Date
of Event which Requires Filing of this Statement) |

If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box [ ].

Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See 240.13d-7(b) for other parties to whom copies are to be sent.

*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

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CUSIP No. 25614T200

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SCHEDULE 13D

CUSIP No. 25614T200

| 1 | NAMES
OF REPORTING PERSONS I.R.S.
IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Heng
Fai Ambrose Chan |
| --- | --- |
| 2 | CHECK
THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)
[ ] (b)
[ ] |
| 3 | SEC
USE ONLY |
| 4 | SOURCE
OF FUNDS (See Instructions) AF
and PF |
| 5 | CHECK
IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E) [ ] |
| 6 | CITIZENSHIP
OR PLACE OF ORGANIZATION Republic
of Singapore |

| NUMBER
OF SHARES BENEFICIALLY OWNED
BY EACH REPORTING PERSON WITH | SOLE
VOTING POWER 2,360,198 (1) |
| --- | --- |
| 8 | SHARED
VOTING POWER |
| 9 | SOLE
DISPOSITIVE POWER 2,360,198 (1) |
| 10 | SHARED
DISPOSITIVE POWER |

| 11 | AGGREGATE
AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 2,360,198 (1) |
| --- | --- |
| 12 | CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions) [ ] |
| 13 | PERCENT
OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 14.04% ( 2) |
| 14 | TYPE
OF REPORTING PERSON (See Instructions) IN |

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1 Consists of (a) 1,174,286 shares of common stock, par value $0.02 per share of Document Security Systems, Inc. (the “ Common Stock ”) held by Heng Fai Holdings Limited (“ Heng Fai Holdings ”), (b) 500,000 shares of Common Stock held by BMI Capital Partners International Limited (“ BMI Capital ”), (c) 683,000 shares of Common Stock held by Hengfai Business Development Pte Ltd. (“ Hengfai Business Development ”), and (d) 2,912 shares of Common Stock held by the Reporting Person.

2 Based on 16,813,523 shares of Common Stock outstanding as of July 6, 2018.

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CUSIP No. 25614T200

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This Amendment No. 1 on Schedule 13D amends the statement on Schedule 13D, filed with the SEC on September 15, 2017, which relates to the Common Stock of the Issuer filed by Heng Fai Ambrose Chan (the “ Reporting Person ”). Except as expressly amended below, the Schedule 13D, filed with the SEC on September 15, 2017 (the “ Original Schedule 13D ”), remains in effect and capitalized terms not defined herein are defined in the Original Schedule 13D.

ITEM 4. Purpose of Transaction

The Reporting Person is in the process of identifying individuals to potentially serve as directors of the Issuer in light of recent changes in the Issuer’s Board of Directors.

The Reporting Person has increased his ownership in the Issuer, and may add to his holdings of the Issuer’s common stock in the future.

ITEM 5. Interest in Securities of the Issuer

| (a) | Personal
ownership by reporting person Heng Fai Ambrose Chan: 2,912 shares of Issuer’s common stock, par value $0.02 per share. |
| --- | --- |
| | Ownership
by affiliate Heng Fai Holdings Limited: 1,174,286 shares of Issuer’s common stock,
par value $0.02 per share. Ownership
by affiliate BMI Capital Partners International Limited: 500,000 shares of Issuer’s common stock, par value $0.02
per share. Ownership
by affiliate Hengfai Business Development Pte. Ltd.: 683,000 shares of Issuer’s common stock, par value $0.02 per
share. |
| (c) | Each
of the required transactions described in this 5(c) were reported on Forms 4 filed by
the Reporting Person filed with the SEC pursuant to Section 16 of the Act and are available
on the SEC’s website at www.sec.gov. The information reported in such filing is
expressly incorporated herein. |

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CUSIP No. 25614T200

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Signature

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

07/06/2018
Dated
/s/
Heng Fai Ambrose Chan
Signature
Heng
Fai Ambrose Chan
Name

The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative (other than an executive officer or general partner of this filing person), evidence of the representative’s authority to sign on behalf of such person shall be filed with the statement, provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath his signature.

Attention: Intentional misstatements or omissions of fact constitute Federal criminal violations (See 18 U.S.C. 1001).

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