SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person^*

COHEN BETSY Z

(Last)

(First)

(Middle)

2929 ARCH STREET, SUITE 1703

(Street)

PHILADELPHIA

19104

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
10/16/2020

3. Issuer Name and Ticker or Trading Symbol
Paya Holdings Inc. [ PAYA ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director		10% Owner
Officer (give title below)	X	Other (specify below)
		Member of 10% owner group

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	1,091,330⁽¹⁾⁽²⁾	I	By Cohen Sponsor Interests III, LLC
Common Stock	25,000⁽²⁾⁽³⁾	I	By FinTech Investor Holdings III, LLC
Common Stock	103,500⁽²⁾⁽⁴⁾	I	By 3FIII, LLC
Common Stock	200,000⁽²⁾	I	By Edward E Cohen Trust dated 10/7/99

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Warrants	11/15/2020	10/16/2025	Common Stock	12,500⁽³⁾	$11.5	I	By FinTech Investor Holdings III, LLC
Warrants	11/15/2020	10/16/2025	Common Stock	51,750⁽⁴⁾	$11.5	I	By 3FIII, LLC

Explanation of Responses:

1. These shares are held directly by FinTech Investor Holdings III, LLC, 3FIII, LLC and FinTech Masala Advisors, LLC, each of which is managed by Cohen Sponsor Interests III, LLC. The reporting person is an indirect owner of Cohen Sponsor Interests III, LLC.

2. The reporting person disclaims beneficial ownership of these securities, except to the extent of her pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for any other purpose.

3. Allocated to the reporting person as a member of FinTech Investor Holdings III, LLC.

4. Allocated to the reporting person as a member of 3FIII, LLC.

	/s/ Amanda Abrams, attorney in fact	10/16/2020
	** 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 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.