Sec Form 4 Filing - Tricor Pacific Capital Partners (Fund IV), ULC @ CPI Card Group Inc. - 2015-10-15

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Tricor Pacific Capital Partners (Fund IV), ULC
2. Issuer Name and Ticker or Trading Symbol
CPI Card Group Inc. [ PMTS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O TRICOR PACIFIC CAPITAL, ONE WESTMINSTER PLACE, SUITE 100
3. Date of Earliest Transaction (MM/DD/YY)
10/15/2015
(Street)
LAKE FOREST, IL60045
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 10/15/2015 S 1,899,605 D $ 9.5 32,794,131 I See footnote ( 1 ) ( 2 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Tricor Pacific Capital Partners (Fund IV), ULC
C/O TRICOR PACIFIC CAPITAL
ONE WESTMINSTER PLACE, SUITE 100
LAKE FOREST, IL60045
X
Tricor Pacific Capital Partners (Fund IV), LP
C/O TRICOR PACIFIC CAPITAL
ONE WESTMINSTER PLACE, SUITE 100
LAKE FOREST, IL60045
X
Tricor Pacific Capital Partners (Fund IV) U.S., LP
C/O TRICOR PACIFIC CAPITAL
ONE WESTMINSTER PLACE, SUITE 100
LAKE FOREST, IL60045
X
Signatures
Tricor Pacific Capital Partners (Fund IV), ULC By: /s/ Bradley Seaman Name: Bradley Seaman Title: Managing Director 10/19/2015
Signature of Reporting Person Date
Tricor Pacific Capital Partners (Fund IV), LP By: Tricor Pacific Capital Partners (Fund IV), ULC, its General Partner By: /s/ Bradley Seaman Name: Bradley Seaman Title: Managing Director 10/19/2015
Signature of Reporting Person Date
Tricor Pacific Capital Partners (Fund IV) US, LP By: Tricor Pacific Capital Partners (Fund IV), ULC, its General Partner By: /s/ Bradley Seaman Name: Bradley Seaman Title: Managing Director 10/19/2015
Signature of Reporting Person Date
Explanation of Responses:
( 1 )1,194,523 shares reported on this line were sold by Tricor Pacific Capital Partners (Fund IV), LP to the underwriters in the initial public offering of CPI Card Group Inc. (the "Company"). Following such sale, Tricor Pacific Capital Partners (Fund IV), LP holds 20,621,843 shares of common stock of the Company. 705,082 shares reported on this line were sold by Tricor Pacific Capital Partners (Fund IV) US, LP to the underwriters in the initial public offering of the Company. Following such sale, Tricor Pacific Capital Partners (Fund IV) US, LP holds 12,172,288 shares of common stock of the Company. Each of Tricor Pacific Capital Partners (Fund IV), LP and Tricor Pacific Capital Partners (Fund IV) US, LP (together, the "Tricor Funds") is managed by Tricor Pacific Capital Partners (Fund IV), ULC, as the general partner.
( 2 )Bradley Seaman, David Rowntree, J. Trevor Johnstone and Roderick Senft are the sole members of an investment committee of the Tricor Funds that has the power to vote or dispose of the shares held by the Tricor Funds. Each member of the investment committee expressly disclaims any beneficial ownership of any shares of common stock held by the Tricor Funds.

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