0001209191-21-009958.txt : 20210211
0001209191-21-009958.hdr.sgml : 20210211
20210211213247
ACCESSION NUMBER: 0001209191-21-009958
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210209
FILED AS OF DATE: 20210211
DATE AS OF CHANGE: 20210211
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bibelheimer Jason
CENTRAL INDEX KEY: 0001771636
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34819
FILM NUMBER: 21622248
MAIL ADDRESS:
STREET 1: 3465 EAST FOOTHILL BOULEVARD
CITY: PASADENA
STATE: CA
ZIP: 91107
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-02-09
0
0001386278
GREEN DOT CORP
GDOT
0001771636
Bibelheimer Jason
3465 EAST FOOTHILL BOULEVARD
PASADENA
CA
91107
0
1
0
0
Chief Human Resources Officer
Class A Common Stock
2021-02-09
4
A
0
14146
0.00
A
92652
D
Class A Common Stock
2021-02-09
4
F
0
1347
54.91
D
91305
D
Represents shares of Class A Common Stock underlying a performance-based restricted stock unit award granted on March 11, 2020. 25% of the award vested on February 9, 2021 and the remaining 75% will vest ratably over the next three years on December 15, 2021, December 15, 2022, and December 15, 2023, subject to the reporting person's provision of service to the issuer on each vesting date.
Represents shares of Class A Common Stock that have been withheld by the issuer to satisfy its income tax withholding and remittance
obligations in connection with the net settlement of the PRSUs, based on a price of $54.91 per share, which represented the closing price of the
issuer's Class A Common Stock on February 9, 2021, and does not represent a sale by the reporting person.
/s/ Lina Davidian as attorney-in-fact for Jason
Bibelheimer
2021-02-11