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Chan Heng Fai Ambrose – ‘4/A’ for 2/24/20 re: Document Security Systems Inc.

On:  Thursday, 3/5/20, at 6:15am ET   ·   For:  2/24/20   ·   Accession #:  1493152-20-3408   ·   File #:  1-32146

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 3/05/20  Chan Heng Fai Ambrose             4/A                    1:7K   Document Security Systems Inc.    M2 Compliance LLC/FA

Amendment to Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4/A         Amendment to Statement of Changes in Beneficial     HTML      3K 
                Ownership of Securities by an Insider --                         
                ownership.xml/3.6


        

This ‘4/A’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 
 
XML Data rendering:  Amendment to Statement of Changes in Beneficial Ownership of Securities by an Insider
 
                                                                                                                                                                                
<?xml version="1.0" encoding="windows-1252"?>
<ownershipDocument>
<schemaVersion> X0306 </schemaVersion>
<documentType> 4/A </documentType>
<periodOfReport> 2020-02-24 </periodOfReport>
<dateOfOriginalSubmission> 2020-02-27 </dateOfOriginalSubmission>
<notSubjectToSection16> 0 </notSubjectToSection16>
<issuer>
<issuerCik> 0000771999 </issuerCik>
<issuerName> DOCUMENT SECURITY SYSTEMS INC </issuerName>
<issuerTradingSymbol> DSS </issuerTradingSymbol>
</issuer>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik> 0001261725 </rptOwnerCik>
<rptOwnerName> Chan Heng Fai Ambrose </rptOwnerName>
</reportingOwnerId>
<reportingOwnerAddress>
<rptOwnerStreet1> C/O DOCUMENT SECURITY SYSTEMS, INC. </rptOwnerStreet1>
<rptOwnerStreet2> 200 CANAL VIEW BLVD., SUITE 300 </rptOwnerStreet2>
<rptOwnerCity> ROCHESTER </rptOwnerCity>
<rptOwnerState> NY </rptOwnerState>
<rptOwnerZipCode> 14623 </rptOwnerZipCode>
<rptOwnerStateDescription></rptOwnerStateDescription>
</reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector> 1 </isDirector>
<isOfficer> 0 </isOfficer>
<isTenPercentOwner> 1 </isTenPercentOwner>
<isOther> 0 </isOther>
<officerTitle></officerTitle>
<otherText></otherText>
</reportingOwnerRelationship>
</reportingOwner>
<nonDerivativeTable>
<nonDerivativeTransaction>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<transactionDate>
<value> 2020-02-24 </value>
</transactionDate>
<deemedExecutionDate></deemedExecutionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> A </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
</transactionCoding>
<transactionTimeliness></transactionTimeliness>
<transactionAmounts>
<transactionShares>
<value> 11111112 </value>
<footnoteId id="F1"/>
</transactionShares>
<transactionPricePerShare>
<value> 0.18 </value>
<footnoteId id="F2"/>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> A </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 13538711 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
</directOrIndirectOwnership>
</ownershipNature>
</nonDerivativeTransaction>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 6446428 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F3"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 1786531 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F4"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 500000 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F5"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 683000 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F6"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
</nonDerivativeTable>
<footnotes>
<footnote id="F1"> The original Form 4 filed on February 27, 2020 is amended by this Form 4 amendment to correctly reflect the reporting person's ownership of Common Stock. No other changes have been made to the original Form 4. </footnote>
<footnote id="F2"> On February 24, 2020, the Reporting Persons purchased from the Issuer 11,111,112 shares of the Issuer's Common Stock, in an underwritten public offering, in consideration for $2,000,000. </footnote>
<footnote id="F3"> Held by LiquidValue Development Pte Ltd., of which Reporting Person is the owner. The Reporting Person has dispositive control over these securities. </footnote>
<footnote id="F4"> Held by Heng Fai Holdings Limited, of which Reporting Person is the owner. The Reporting Person has dispositive control over these securities. </footnote>
<footnote id="F5"> Held by BMI Capital Partners International Limited, of which the Reporting Person is an owner and director. The Reporting Person has dispositive control over these securities. </footnote>
<footnote id="F6"> Held by Hengfai Business Development Pte Ltd, of which Reporting Person is the Chief Executive Officer and Owner. The Reporting Person has dispositive control over these securities </footnote>
</footnotes>
<ownerSignature>
<signatureName> /s/ Chan Heng Fai Ambrose </signatureName>
<signatureDate> 2020-03-05 </signatureDate>
</ownerSignature>
</ownershipDocument>


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Filing Submission 0001493152-20-003408   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)
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