SC 13D/A 1 sc13da.htm

 

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

SCHEDULE 13D/A

 

Under the Securities Exchange Act of 1934

(Amendment No. 12)

 

DOCUMENT SECURITY SYSTEMS, INC.
(Name of Issuer)

 

Common Stock, par value $0.02 per share
(Title of Class of Securities)

 

25614T200
(CUSIP Number)

 

Heng Fai Ambrose Chan

c/o Alset International Limited

7 Temasek Boulevard #29-01B, Suntec Tower One

Singapore 038987

011 65 6333 9181

(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)

 

June 15, 2021
(Date of Event which Requires Filing of this Statement)

 

If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. [  ]

 

Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See § 240.13d-7 for other parties to whom copies are to be sent.

 

*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

 

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

 

   
 

 

CUSIP No. 25614T200  

 

1

NAMES OF REPORTING PERSON

I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

 

Heng Fai Ambrose Chan
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)

(a) [  ]

(b) [  ]

3

SEC USE ONLY

 

 
4

SOURCE OF FUNDS (See Instructions)

OO

 
5 CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E)
[  ]
6 CITIZENSHIP OR PLACE OF ORGANIZATION
Republic of Singapore

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON

WITH

7 SOLE VOTING POWER:
10,036,164(1)
8 SHARED VOTING POWER:
 
9 SOLE DISPOSITIVE POWER:
10,036,164(1)
10 SHARED DISPOSITIVE POWER:
 

11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
10,036,164(1)
12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions)
[  ]
13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
14.8%(2)
14 TYPE OF REPORTING PERSON (See Instructions)
IN

 

(1) The beneficial ownership of Heng Fai Ambrose Chan (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.

 

(2) Based on 67,590,295 shares of the Common Stock of the Issuer outstanding.

 

   
 

 

CUSIP No. 25614T200  

 

1

NAMES OF REPORTING PERSON

I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

 

Global Biomedical Pte. Ltd.

2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)

(a) [  ]

(b) [  ]

3

SEC USE ONLY

 

 
4

SOURCE OF FUNDS (See Instructions)

OO

 
5 CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E)
[  ]
6 CITIZENSHIP OR PLACE OF ORGANIZATION
Republic of Singapore

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON

WITH

7 SOLE VOTING POWER:
7,716,004
8 SHARED VOTING POWER:
 
9 SOLE DISPOSITIVE POWER:
7,716,004
10 SHARED DISPOSITIVE POWER:
 

11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
7,716,004
12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions)
[  ]
13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
11.4%(1)
14 TYPE OF REPORTING PERSON (See Instructions)
CO

 

(1) Based on 67,590,295 shares of the Common Stock of the Issuer outstanding.

 

This Amendment No. 12 on Schedule 13D amends and restates the statement on Schedule 13D, filed with the SEC on September 15, 2017, as amended by Amendment No. 1, filed with the SEC on July 6, 2018, Amendment No. 2, filed with the SEC on December 18, 2018, Amendment No. 3, filed on February 20, 2019, Amendment No. 4, filed on March 27, 2019, Amendment No. 5, filed on June 11, 2019, Amendment No. 6, filed on July 23, 2019, Amendment No. 7, filed on November 5, 2019, Amendment No 8, filed on March 4, 2020, Amendment No. 9 on September 1, 2020, Amendment No. 10 on October 26, 2020 and Amendment No. 11 on June 3, 2021, which relates to the Common Stock of the Issuer filed by Heng Fai Ambrose Chan.

 

   
 

 

Item 1. Security and Issuer

 

The title and class of equity securities to which this Amendment No. 12 to the Schedule 13D relates is the common stock, $0.02 par value per share, of Document Security Systems, Inc. (“Common Stock”), a New York Corporation (the “Issuer”). The principal offices of the Issuer are located at 6 Framark Drive, Victor, NY 14564.

 

Item 3. Source and Amount of Funds or Other Considerations

 

Item 3 of the Schedule 13D is hereby amended to include the following:

 

On June 15, 2021, Heng Fai Holdings Limited, an entity owned by Mr. Chan, purchased 115,960 shares of Common Stock for $1.77 per share and 884,040 shares of Common Stock for $1.69 per share.

 

On June 16, 2021, Heng Fai Holdings Limited, an entity owned by Mr. Chan, purchased 555,000 shares of Common Stock for $1.70 per share.

 

On June 21, 2021, Global Biomedical converted 7,259 shares of the Issuer’s Series A Convertible Preferred Stock into 1,120,170 shares of the Common Stock of the Issuer.

 

Item 5. Interest in Securities of the Issuer

 

(a)-(b) The responses to Items 7 - 13 of the cover pages of this Schedule 13D are incorporated herein by reference.

 

(c) None.

 

(d) None

 

(e) N/A

 

Item 7. Material to be Filed as Exhibits.

 

Exhibit 99.1 Joint Filing Agreement with Global Biomedical Pte. Ltd. (incorporated by reference to Amendment No. 9 to the Schedule 13D filed on September 1, 2020)

 

   
 

 

SIGNATURE

 

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

 

Dated: June 25, 2021 /s/ Heng Fai Ambrose Chan
  Name: Heng Fai Ambrose Chan
     
  Global Biomedical Pte. Ltd.
     
  /s/ Heng Fai Ambrose Chan
  Name:  Heng Fai Ambrose Chan
  Title: Director