0001493152-23-041704.txt : 20231116
0001493152-23-041704.hdr.sgml : 20231116
20231116170104
ACCESSION NUMBER: 0001493152-23-041704
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230804
FILED AS OF DATE: 20231116
DATE AS OF CHANGE: 20231116
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Oppen Sean Matthew
CENTRAL INDEX KEY: 0001999565
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40809
FILM NUMBER: 231415367
MAIL ADDRESS:
STREET 1: 3121 NORTH BAY RD
CITY: MIAMI BEACH
STATE: FL
ZIP: 33140
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: EzFill Holdings Inc
CENTRAL INDEX KEY: 0001817004
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500]
IRS NUMBER: 834260623
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 67 NW 183RD ST
CITY: MIAMI
STATE: FL
ZIP: 33169
BUSINESS PHONE: 305-791-1169
MAIL ADDRESS:
STREET 1: 67 NW 183RD ST
CITY: MIAMI
STATE: FL
ZIP: 33169
4
1
ownership.xml
X0508
4
2023-08-04
0
0001817004
EzFill Holdings Inc
EZFL
0001999565
Oppen Sean Matthew
C/O EZFILL HOLDINGS INC.
67 NW 183RD STREET
MIAMI
FL
33169
1
0
0
0
0
Restricted Common Stock
2023-08-04
4
A
0
54714
1.98
A
54714
D
The shares will fully vest in 12 months from the grant date. Should the Reporting Person leave the Issuer's board of directors prior to vesting, the Reporting Person will be awarded a grant on a pro rata basis based on the time spent as a member of the board of directors. The number of shares is based on annual director compensation of $130,000 per the Issuer's director compensation agreement with the Reporting Person and the closing price $1.98 on August 4, 2023.
Granted pursuant to the EzFill Holdings, Inc. 2023 Equity Incentive Plan.
The number of shares reflects a one-for-eight reverse split effective on April 27, 2023.
/s/ Sean Oppen
2023-11-16