0001209191-13-041799.txt : 20130822 0001209191-13-041799.hdr.sgml : 20130822 20130822183819 ACCESSION NUMBER: 0001209191-13-041799 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130712 FILED AS OF DATE: 20130822 DATE AS OF CHANGE: 20130822 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GREEN DOT CORP CENTRAL INDEX KEY: 0001386278 STANDARD INDUSTRIAL CLASSIFICATION: FINANCE SERVICES [6199] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3465 E. FOOTHILL BLVD CITY: PASADENA STATE: CA ZIP: 91107 BUSINESS PHONE: 6267652000 MAIL ADDRESS: STREET 1: 3465 E. FOOTHILL BLVD CITY: PASADENA STATE: CA ZIP: 91107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Keatley John L CENTRAL INDEX KEY: 0001494442 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34819 FILM NUMBER: 131056057 MAIL ADDRESS: STREET 1: 605 E. HUNTINGTON DRIVE, SUITE 205 CITY: MONROVIA STATE: CA ZIP: 91016 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2013-07-12 0 0001386278 GREEN DOT CORP GDOT 0001494442 Keatley John L 3465 EAST FOOTHILL BOULEVARD PASADENA CA 91107 0 1 0 0 Chief Financial Officer Class A Common Stock 2013-07-12 4 C 0 34538 0.00 A 97931 D Class A Common Stock 6600 I By minor children Class B Common Stock 0.00 2013-07-12 4 C 0 34538 0.00 D Class A Common Stock 34538 0 D Represents the number of shares that were acquired upon conversion of Class B Common Stock to Class A Common Stock at the election of the holder. The Class B Common Stock is convertible at the holder's option into the issuer's Class A Common Stock on a 1-for-1 basis and has no expiration date. The holder elected to convert the shares of Class B Common Stock into Class A Common Stock, which Class A Common Stock has no exercisable date or expiration date. /s/ Lina Davidian as attorney-in-fact for John L. Keatley 2013-08-22