Sec Form 4 Filing - BELL ERIC CHRISTOPHER @ Paya Holdings Inc. - 2023-02-22

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
BELL ERIC CHRISTOPHER
2. Issuer Name and Ticker or Trading Symbol
Paya Holdings Inc. [ PAYA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Accounting Officer
(Last) (First) (Middle)
303 PERIMETER CENTER NORTH, SUITE 600
3. Date of Earliest Transaction (MM/DD/YY)
02/22/2023
(Street)
ATLANTA, GA30346
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ 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 02/22/2023 U 13,538 D ( 1 ) $ 9.75 0 D
Common Stock 02/22/2023 D 64,265 D 0 D
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
Stock Option (right to buy) $ 5.12 02/22/2023 D( 1 ) 28,571 ( 3 ) 03/16/2032 Common Stock 28,571 ( 3 ) 0 D
Stock Option (right to buy) $ 1,373 02/22/2023 D( 1 ) 35,000 ( 3 ) 12/22/2030 Common Stock 35,000 ( 3 ) 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
BELL ERIC CHRISTOPHER
303 PERIMETER CENTER NORTH
SUITE 600
ATLANTA, GA30346
Chief Accounting Officer
Signatures
/s/ Glenn Renzulli, by Power of Attorney 02/24/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Pursuant to the Agreement and Plan of Merger, dated as of January 8, 2023, by and among Paya Holdings Inc., Nuvei Corporation, a corporation incorporated pursuant to the laws of Canada and Pinnacle Merger Sub, Inc.
( 2 )Each of the Issuer's RSU outstanding and vested as of immediately prior to the Effective Time, was cancelled and converted into the right to receive a lump sum cash payment. Any RSUs that were outstanding and unvested as of immediately prior to the Effective Time were converted into a restricted stock unit award.
( 3 )Each of the Issuer's Options outstanding and vested as of Effective Time and had an exercise price less than $9.75 per Share was cancelled and converted into the right to receive a lump sum cash payment. The Option that was outstanding and unvested as of immediately prior to the Effective Time and that had an exercise price less than the Offer Price was converted into an option to purchase a number of subordinate voting shares of Parent.

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