Sec Form 4 Filing - FIELDS RANDALL K @ PARK CITY GROUP INC - 2019-05-16

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
FIELDS RANDALL K
2. Issuer Name and Ticker or Trading Symbol
PARK CITY GROUP INC [ PCYG]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
CHIEF EXECUTIVE OFFICER
(Last) (First) (Middle)
C/O PARK CITY GROUP, INC., 5282 S COMMERCE DRIVE, SUITE D-292
3. Date of Earliest Transaction (MM/DD/YY)
05/16/2019
(Street)
MURRAY, UT84107
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 05/16/2019 P 2,200 A $ 6.8672 3,708,289 D
Common Stock 654,693 I By Riverview Financial Corp.
Common Stock 30,667 I By Spouse
Common Stock 1,289,230 I By Fields Management
Series B Preferred Stock 531,432 I By Riverview Financial Corp
Series B Preferred Stock 14,450 I By Spouse
Common Stock 205,000 I By Charitable 2010, LLC
Series B-1 Preferred Stock 121,936 I By Fields Management, Inc.
Series B-1 Preferred Stock 78,123 I By Riverview Financial Corp
Series B-1 Preferred Stock 657 I By Spouse
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
Warrant $ 10 01/26/2015 01/26/2020 Common Stock 3,165 3,165 D
Warrants $ 4 02/05/2015 02/05/2020 Common Stock 914,065 914,065 I By Riverview Financial Corp
Warrants $ 4 02/05/2015 02/05/2020 Common Stock 40,250 40,250 I By Spouse
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
FIELDS RANDALL K
C/O PARK CITY GROUP, INC.
5282 S COMMERCE DRIVE, SUITE D-292
MURRAY, UT84107
X X CHIEF EXECUTIVE OFFICER
Signatures
/s/ Randall K. Fields 05/16/2019
Signature of Reporting Person Date
Explanation of Responses:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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