Sec Form 4 Filing - Chan Heng Fai Ambrose @ DOCUMENT SECURITY SYSTEMS INC - 2021-06-21

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 Chan Heng Fai Ambrose 2. Issuer Name and Ticker or Trading Symbol DOCUMENT SECURITY SYSTEMS INC [ DSS] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X __ Director X __ 10% Owner _____ Officer (give title below) _____ Other (specify below) (Last) (First) (Middle) C/O DOCUMENT SECURITY SYSTEMS, INC., 6 FRAMARK DRIVE 3. Date of Earliest Transaction (MM/DD/YY) 06/21/2021 (Street) VICTOR, NY14564 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 06/21/2021 C( 1 ) 1,120,170 A 10,036,164 ( 3 ) I See footnote ( 4 )

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 Series A Convertible Preferred Stock ( 2 ) 06/21/2021 C( 1 ) 7,259 ( 2 ) ( 2 ) Common S tock 1,120,170 ( 2 ) 0 I See footnote ( 4 )

Reporting Owners Reporting Owner Name / Address Relationships Director 10% Owner Officer Other Chan Heng Fai Ambrose C/O DOCUMENT SECURITY SYSTEMS, INC. 6 FRAMARK DRIVE VICTOR, NY14564 X X Global BioMedical Pte. Ltd. 7 TEMASEK BOULEVARD #29-01B, SUNTEC TOWER ONE SINGAPORE, U014564 X Signatures /s/ Heng Fai Ambrose Chan 06/23/2021 Signature of Reporting Person Date /s/ Global BioMedical Pte. Ltd by Heng Fai Ambrose Chan 06/23/2021 Signature of Reporting Person Date

Explanation of Responses:

( 1 )Global BioMedical Pte. Ltd. ("GBM") has converted 7,259 shares of Series A Convertible Preferred Stock into 1,120,170 shares of the common stock, par value $0.02 per share (the "Common Stock"), of Document Security Systems, Inc. (the "Issuer"). ( 2 )The Series A Convertible Preferred Stock of the Issuer has a stated value of $1,000 per share and may be converted into shares of the Common Stock of the Issuer at a conversion price of $6.48 per share. Following the conversion of 7,259 shares of Series A Convertible Preferred Stock, GBM does not own any shares of Series A Convertible Preferred Stock. Mr. Chan has dispositive control over the securities owned by GBM. ( 3 )The beneficial ownership of the Reporting Person includes 10,036,164 shares of Common Stock, consisting of (a) 1,614,552 shares of Common Stock held by Heng Fai Holdings Limited; (b) 16,667 shares of Common Stock held by BMI Capital Partners International Limited; (c) 474,060 shares of Common Stock held by the Reporting Person; (d) 214,881 shares of Common Stock held by LiquidValue Development Pte Ltd.; and (e) 7,716,004 shares of Common Stock held by Global Biomedical Pte. Ltd. ( 4 )These securities were owned directly by GBM. Mr. Chan has dispositive control over the securities of the Issuer owned by GBM.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

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