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