<SEC-DOCUMENT>0001493152-17-010498.txt : 20170912
<SEC-HEADER>0001493152-17-010498.hdr.sgml : 20170912
<ACCEPTANCE-DATETIME>20170912170014
ACCESSION NUMBER:		0001493152-17-010498
CONFORMED SUBMISSION TYPE:	4
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20170908
FILED AS OF DATE:		20170912
DATE AS OF CHANGE:		20170912

REPORTING-OWNER:	

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

	FILING VALUES:
		FORM TYPE:		4
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-32146
		FILM NUMBER:		171081637

	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

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
</SEC-HEADER>
<DOCUMENT>
<TYPE>4
<SEQUENCE>1
<FILENAME>form4.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0306</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2017-09-08</periodOfReport>

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

    <nonDerivativeTable>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <transactionDate>
                <value>2017-09-08</value>
            </transactionDate>
            <deemedExecutionDate></deemedExecutionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>P</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionTimeliness></transactionTimeliness>
            <transactionAmounts>
                <transactionShares>
                    <value>800000</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0.75</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>1100000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>2611</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Warrants</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>1.00</value>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2017-09-08</value>
            </transactionDate>
            <deemedExecutionDate></deemedExecutionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>P</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionTimeliness></transactionTimeliness>
            <transactionAmounts>
                <transactionShares>
                    <value>160000</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0</value>
                    <footnoteId id="F3"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <value>2017-09-08</value>
            </exerciseDate>
            <expirationDate>
                <value>2022-09-08</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>160000</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>160000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F2"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeTransaction>
        <derivativeHolding>
            <securityTitle>
                <value>Warrants</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>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>200000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F2"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">The Reporting Person is a director of BMI Capital Partners International Ltd. (&quot;BMI Capital&quot;), which owns 300,000 shares of the Issuer's common stock purchased on 12/29/16. The Reporting Person is also the CEO and majority shareholder of Heng Fai Holdings Limited (&quot;HF Holdings&quot;), which owns the 800,000 shares of Issuer's common stock purchased on 9/8/17. Reporting Person has dispositive control over all of these shares.</footnote>
        <footnote id="F2">BMI capital owns the previously issued warrants to purchase 200,000 shares of the Issuer's common stock. HF Holdings owns the warrants to purchase 160,000 shares of Issuer's common stock. Reporting Person has dispositive control over all of these warrants.</footnote>
        <footnote id="F3">The price of the warrants is included in the price of the shares reported in Table I.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Heng Fai Ambrose Chan</signatureName>
        <signatureDate>2017-09-12</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
