<SEC-DOCUMENT>0001493152-20-019900.txt : 20201023
<SEC-HEADER>0001493152-20-019900.hdr.sgml : 20201023
<ACCEPTANCE-DATETIME>20201023175611
ACCESSION NUMBER:		0001493152-20-019900
CONFORMED SUBMISSION TYPE:	4
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20201016
FILED AS OF DATE:		20201023
DATE AS OF CHANGE:		20201023

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:		201258647

	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

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Global BioMedical Pte. Ltd.
		CENTRAL INDEX KEY:			0001823066

	FILING VALUES:
		FORM TYPE:		4
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-32146
		FILM NUMBER:		201258648

	BUSINESS ADDRESS:	
		BUSINESS PHONE:		3019713940

	MAIL ADDRESS:	
		STREET 1:		7 TEMASEK BOULEVARD #29-01B
		STREET 2:		SUNTEC TOWER ONE
		CITY:			SINGAPORE
		STATE:			U0
		ZIP:			038987

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 104
		CITY:			ROCHESTER
		STATE:			NY
		ZIP:			14623
		BUSINESS PHONE:		585 232 1500

	MAIL ADDRESS:	
		STREET 1:		200 CANAL VIEW BOULEVARD
		STREET 2:		SUITE 104
		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>ownership.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0306</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2020-10-16</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 104</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>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001823066</rptOwnerCik>
            <rptOwnerName>Global BioMedical Pte. Ltd.</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>7 TEMASEK BOULEVARD #29-01B,</rptOwnerStreet1>
            <rptOwnerStreet2>SUNTEC TOWER ONE</rptOwnerStreet2>
            <rptOwnerCity>SINGAPORE</rptOwnerCity>
            <rptOwnerState>U0</rptOwnerState>
            <rptOwnerZipCode>14564</rptOwnerZipCode>
            <rptOwnerStateDescription>SINGAPORE</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</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>2020-10-16</value>
            </transactionDate>
            <deemedExecutionDate></deemedExecutionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>C</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
                <footnoteId id="F1"/>
            </transactionCoding>
            <transactionTimeliness></transactionTimeliness>
            <transactionAmounts>
                <transactionShares>
                    <value>662500</value>
                </transactionShares>
                <transactionPricePerShare>
                    <footnoteId id="F2"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>1145834</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See footnote</value>
                    <footnoteId id="F3"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
    </nonDerivativeTable>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Series A Convertible Preferred Stock</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F2"/>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2020-10-16</value>
            </transactionDate>
            <deemedExecutionDate></deemedExecutionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>C</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
                <footnoteId id="F1"/>
            </transactionCoding>
            <transactionTimeliness></transactionTimeliness>
            <transactionAmounts>
                <transactionShares>
                    <value>4293</value>
                </transactionShares>
                <transactionPricePerShare>
                    <footnoteId id="F2"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>D</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F2"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>662500</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>42575</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See footnote</value>
                    <footnoteId id="F3"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeTransaction>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">Global BioMedical Pte. Ltd. (&quot;GBM&quot;) has converted 4,293 shares of Series A Convertible Preferred Stock into 662,500 shares of the common stock of Document Security Systems, Inc. (the &quot;Issuer&quot;).</footnote>
        <footnote id="F2">The Series A Convertible Preferred Stock of the Issuer has a stated value of $1,000 per share and may be converted into shares of the common stock of the Issuer at a conversion price of $6.48 per share, subject to a 19.99% beneficial ownership conversion limitation (the &quot;Blocker&quot;) based on the total issued and outstanding shares of common stock of the Issuer beneficially owned by GBM. There are currently 5,836,212 shares of the Issuer's common stock issued and outstanding, and therefore, as a result of the Blocker, GBM is currently able to convert an additional 168 shares of Series A Preferred Stock, equal to 25,925 shares of the Issuer's common stock. Mr. Chan has dispositive control over the securities owned by GBM.</footnote>
        <footnote id="F3">These securities are owned directly by GBM. Mr. Chan has dispositive control over the common stock and Series A Convertible Preferred Stock of the Issuer owned by GBM.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Heng Fai Ambrose Chan</signatureName>
        <signatureDate>2020-10-23</signatureDate>
    </ownerSignature>

    <ownerSignature>
        <signatureName>/s/ Global BioMedical Pte. Ltd., by Heng Fai Ambrose Chan</signatureName>
        <signatureDate>2020-10-23</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
