0001712923-22-000002.txt : 20220214 0001712923-22-000002.hdr.sgml : 20220214 20220214164426 ACCESSION NUMBER: 0001712923-22-000002 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220214 DATE AS OF CHANGE: 20220214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Zalik David CENTRAL INDEX KEY: 0001740339 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38506 FILM NUMBER: 22633578 MAIL ADDRESS: STREET 1: 5565 GLENRIDGE CONNECTOR, SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30342 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GreenSky, Inc. CENTRAL INDEX KEY: 0001712923 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 822135346 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5565 GLENRIDGE CONNECTOR STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30342 BUSINESS PHONE: 678-264-6105 MAIL ADDRESS: STREET 1: 5565 GLENRIDGE CONNECTOR STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30342 5 1 wf-form5_164487502990108.xml FORM 5 X0306 5 2021-12-31 0 0 0 0001712923 GreenSky, Inc. GSKY 0001740339 Zalik David 5565 GLENRIDGE CONNECTOR, SUITE 700 ATLANTA GA 30342 1 1 1 0 CEO and Chairman of the Board Class A common stock 1105220 D Class B common stock 2021-09-13 5 G 0 6635735 0 D 44354509 I Founders Technology Investors, LLC Class B common stock 13397399 I Financial Technology Investors, LLC Holdco Units 2021-09-13 5 G 0 6635735 0 D Class A common stock 50990244.0 44354509 I Founders Technology Investors, LLC Holdco Units Class A common stock 13397399.0 13397399 I Financial Technology Investors, LLC Pursuant to the Exchange Agreement, dated May 23, 2018, by and among the Issuer, GreenSky Holdings, LLC ("GS Holdings") and the members of GS Holdings, the Holdco Units may be exchanged by the Reporting Person (with automatic cancellation of an equal number of shares of Class B common stock) for shares of Class A common stock on a one-for-one basis, subject to customary adjustments for stock splits, stock dividends, reclassifications and other similar transactions, stock repurchases and other reinvestments of excess cash, or for cash (based on the market price of the shares of Class A common stock), at the Issuer's option. /s/ Steven E. Fox, as attorney-in-fact 2022-02-10