0001651557-15-000001.txt : 20150824 0001651557-15-000001.hdr.sgml : 20150824 20150824103047 ACCESSION NUMBER: 0001651557-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150824 DATE AS OF CHANGE: 20150824 EFFECTIVENESS DATE: 20150824 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PaySpan Holding Corp. CENTRAL INDEX KEY: 0001651557 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-246289 FILM NUMBER: 151070229 BUSINESS ADDRESS: STREET 1: 7751 BELFORT PARKWAY STREET 2: SUITE 200 CITY: JACKSONVILLE STATE: FL ZIP: 32256 BUSINESS PHONE: 877-331-7154 MAIL ADDRESS: STREET 1: 7751 BELFORT PARKWAY STREET 2: SUITE 200 CITY: JACKSONVILLE STATE: FL ZIP: 32256 D 1 primary_doc.xml X0707 D LIVE 0001651557 PaySpan Holding Corp. 7751 BELFORT PARKWAY SUITE 200 JACKSONVILLE FL FLORIDA 32256 877-331-7154 DELAWARE Payformance Holding Corp. None Corporation true Rex Adams c/o PaySpan, Inc. Two Ravinia Drive, Suite 1710 Atlanta GA GEORGIA 30346 Executive Officer Director Calbraith Wheaton c/o PaySpan, Inc. Two Ravinia Drive, Suite 1710 Atlanta GA GEORGIA 30346 Director Timothy Weglicki c/o PaySpan, Inc. Two Ravinia Drive, Suite 1710 Atlanta GA GEORGIA 30346 Director Yumin Choi c/o PaySpan, Inc. Two Ravinia Drive, Suite 1710 Atlanta GA GEORGIA 30346 Director Reese Porter c/o PaySpan, Inc. Two Ravinia Drive, Suite 1710 Atlanta GA GEORGIA 30346 Executive Officer Other Health Care Decline to Disclose 06b false 2015-08-12 false true false 0 3100000 3000000 100000 false 2 0 0 0 false PaySpan Holding Corp. /s/ Steven Russell Steven Russell Chief Financial Officer 2015-08-24