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Ownership Document
|
| Schema Version: X0306 |
| Document Type: 4 |
| Period of Report: 9/20/19 |
| Not Subject to Section 16: 0 |
| Issuer: |
| Issuer CIK: 1720592 |
| Issuer Name: Repay Holdings Corp |
| Issuer Trading Symbol: RPAY |
| Reporting Owner: |
| Reporting Owner ID: |
| | Owner CIK: 1369635 |
| | Owner Name: THORNBURGH RICHARD E |
| Reporting Owner Address: |
| | Owner Street 1: C/O REPAY HOLDINGS CORPORATION |
| | Owner Street 2: 3 WEST PACES FERRY ROAD, SUITE 200 |
| | Owner City: ATLANTA |
| | Owner State: GA |
| | Owner ZIP Code: 30305 |
| | Owner State Description: |
| Reporting Owner Relationship: |
| | Is Director? Yes |
| | Is Officer? No |
| | Is Ten Percent Owner? No |
| | Is Other? No |
| | Officer Title: |
| | Other Text: |
| Non-Derivative Table: |
| Non-Derivative Transaction: |
| | Security Title: |
| | | Value: Class A Common Stock |
| | Transaction Date: |
| | | Value: 9/20/19 |
| | Deemed Execution Date: |
| | Transaction Coding: |
| | | Transaction Form Type: 4 |
| | | Transaction Code: A |
| | | Equity Swap Involved? No |
| | | Footnote ID: F1 |
| | Transaction Timeliness: |
| | Transaction Amounts: |
| | | Transaction Shares: |
| Value: 12,445 |
| | | Transaction Price Per Share: |
| Value: 0 |
| | | Transaction Acquired-Disposed Code: |
| Value: A |
| | Post-Transaction Amounts: |
| | | Shares Owned Following Transaction: |
| Value: 12,445 |
| | Ownership Nature: |
| | | Direct or Indirect Ownership: |
| Value: D |
| Footnote ID: F2 |
| Footnotes: |
| Footnote - F1: Reflects a grant of restricted stock units that vest on the earlier of: (a) the one-year anniversary of the grant date, and (b) the next regularly scheduled annual meeting of the stockholders of the Issuer following the grant date. The shares subject to the units will be issued to the Reporting Person after the Reporting Person ceases to be a director of the Issuer pursuant to the terms of the award agreement. |
| Footnote - F2: The Reporting Person is a senior adviser of Corsair Capital LLC or one of its affiliates ("collectively, "Corsair"). Pursuant to arrangements, a portion of the value of these securities or of any disposition of these securities will be applied against certain management fees payable to Corsair pursuant to applicable fund documents. |
| Owner Signature: |
| Signature Name: /s/ Timothy J. Murphy, as Attorney-in-Fact |
| Signature Date: 9/24/19 |
