SEC FORM 4 SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Sidhom Rafik R

(Last) (First) (Middle)
C/O EVO PAYMENTS, 10 GLENLAKE PKWY,
SOUTH TOWER, SUITE 950

(Street)
ATLANTA GA 30328

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
EVO Payments, Inc. [ EVOP ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
08/15/2019
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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
Class B Common Stock, par value $0.0001 per share(1) 08/15/2019 D 750,000 D $28.25 34,663,538 I See footnote(2)
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: 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
1. Name and Address of Reporting Person*
Sidhom Rafik R

(Last) (First) (Middle)
C/O EVO PAYMENTS, 10 GLENLAKE PKWY,
SOUTH TOWER, SUITE 950

(Street)
ATLANTA GA 30328

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Blueapple, Inc.

(Last) (First) (Middle)
10 GLENLAKE PARKWAY, SOUTH TOWER
SUITE 950

(Street)
ATLANTA GA 30328

(City) (State) (Zip)
Explanation of Responses:
1. Each share of Class B common stock of EVO Payments, Inc. (the "Issuer") is paired with one unit of EVO Investco, LLC (each, an "LLC Interest"). This disposition reflects the transfer (and subsequent cancellation) of Class B common stock to the Issuer received in connection with the sale and transfer to the Issuer of a corresponding number of LLC Interests pursuant to the terms of the Second Amended and Restated Limited Liability Company Agreement of EVO Investco, LLC.
2. The shares of Class B common stock are held of record by Blueapple, Inc. ("Blueapple"). Blueapple is controlled by its majority stockholder, Mr. Sidhom, who is the founder and chairman of the board of directors of Blueapple. Mr. Sidhom may be deemed to share beneficial ownership of the reported securities. Mr. Sidhom disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
/s/ Steven J. de Groot, attorney-in-fact 08/15/2019
/s/ Steven J. de Groot, attorney-in-fact 08/15/2019
** Signature of Reporting Person Date
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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