<SEC-DOCUMENT>0001493152-17-000604.txt : 20170118
<SEC-HEADER>0001493152-17-000604.hdr.sgml : 20170118
<ACCEPTANCE-DATETIME>20170118162326
ACCESSION NUMBER:		0001493152-17-000604
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20170112
FILED AS OF DATE:		20170118
DATE AS OF CHANGE:		20170118

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			DOCUMENT SECURITY SYSTEMS INC
		CENTRAL INDEX KEY:			0000771999
		STANDARD INDUSTRIAL CLASSIFICATION:	PAPERBOARD CONTAINERS & BOXES [2650]
		IRS NUMBER:				161229730
		STATE OF INCORPORATION:			NY
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		200 CANAL VIEW BOULEVARD
		STREET 2:		SUITE 300
		CITY:			ROCHESTER
		STATE:			NY
		ZIP:			14623
		BUSINESS PHONE:		585 232 1500

	MAIL ADDRESS:	
		STREET 1:		200 CANAL VIEW BOULEVARD
		STREET 2:		SUITE 300
		CITY:			ROCHESTER
		STATE:			NY
		ZIP:			14623

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	NEW SKY COMMUNICATIONS INC
		DATE OF NAME CHANGE:	19920703

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	THOROUGHBREDS USA INC
		DATE OF NAME CHANGE:	19861118

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Chan Heng Fai Ambrose
		CENTRAL INDEX KEY:			0001261725

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-32146
		FILM NUMBER:		17533704

	MAIL ADDRESS:	
		STREET 1:		2601 INSLAND PLACE TOWER
		STREET 2:		510 KINGS RD N POINT
		CITY:			HONG KONG
		STATE:			K3
		ZIP:			999999999

	FORMER NAME:	
		FORMER CONFORMED NAME:	CHAN FAI
		DATE OF NAME CHANGE:	20030828
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>form3.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2017-01-12</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <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>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>2611</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>300000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <derivativeTable>
        <derivativeHolding>
            <securityTitle>
                <value>Warrants (right to purchase common stock)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>1.00</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2016-12-29</value>
            </exerciseDate>
            <expirationDate>
                <value>2019-12-29</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>200000</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">The Reporting Person is a director of BMI Capital Partners International Ltd., which owns 300,000 shares of the Issuer's common stock and warrants to purchase 200,000 shares of the Issuer's common stock, over which the Reporting Person has dispositive control.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Heng Fai Ambrose Chan</signatureName>
        <signatureDate>2017-01-18</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
