SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Wayzata Investment Partners LLC

(Last) (First) (Middle)
ONE CARLSON PARKWAY NORTH, SUITE 220

(Street)
PLYMOUTH MN 55447

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Lazydays Holdings, Inc. [ LAZY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
09/16/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 09/16/2021 J(1) 1,967,841 D $0.00 93,679 I See footnote(2)
Common Stock 09/16/2021 J(1) 283,438 D $0.00 14,947 I See footnote(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Wayzata Investment Partners LLC

(Last) (First) (Middle)
ONE CARLSON PARKWAY NORTH, SUITE 220

(Street)
PLYMOUTH MN 55447

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Halloran Patrick J.

(Last) (First) (Middle)
ONE CARLSON PARKWAY NORTH SUITE 220

(Street)
PLYMOUTH MN 55447

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
WAYZATA OPPORTUNITIES FUND II, L.P.

(Last) (First) (Middle)
ONE CARLSON PARKWAY NORTH SUITE 220

(Street)
PLYMOUTH MN 55447

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Wayzata Opportunities Fund Offshore II, L.P.

(Last) (First) (Middle)
ONE CARLSON PARKWAY NORTH SUITE 220

(Street)
PLYMOUTH MN 55447

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. This transaction represents the distribution of shares by the reporting persons pursuant to a pro rata distribution, without consideration, of shares of the Issuer's common stock effected on September 16, 2021 to its general partners and limited partners. The distribution of the shares received in this distribution is exempt pursuant to Rule 16a-9.
2. Wayzata Opportunities Fund II, L.P
3. Wayzata Opportunities Fund Offshore II, L.P.
/s/ Patrick J. Halloran Wayzata Investment Partners LLC, by Patrick J. Halloran, Manager 09/22/2021
/s/ Patrick J. Halloran 09/22/2021
/s/ Patrick J. Halloran WAYZATA OPPORTUNITIES FUND II, L.P., by WOF II GP, L.P., its General Partner, by: WOF II GP, LLC, its General Partner, by: Patrick J. Halloran, Authorized Signatory 09/22/2021
/s/ Patrick J. Halloran WAYZATA OPPORTUNITIES FUND OFFSHORE II, L.P., by Wayzata Offshore GP II, LLC, its General Partner, Patrick J. Halloran, Authorized Signatory 09/22/2021
** 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 4 (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).
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