SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Sod Jacob

(Last)

(First)

(Middle)

14 WALL STREET, SUITE 2064

(Street)

NEW YORK

10005

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
09/14/2021

3. Issuer Name and Ticker or Trading Symbol
EzFill Holdings Inc [ EZFL ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director	X	10% Owner
Officer (give title below)		Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	6,287,525	I	LH MA 2 LLC and Crestview 360 Holdings LLC⁽¹⁾⁽²⁾

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Stock Option (right to buy)	07/09/2019	07/09/2024	Common Stock	7,440	$1.35	I	LH MA 2 LLC⁽³⁾
Stock Option (right to buy)	07/12/2019	07/12/2024	Common Stock	7,440	$1.35	I	LH MA 2 LLC⁽³⁾
Stock Option (right to buy)	07/29/2019	07/29/2024	Common Stock	7,440	$1.35	I	LH MA 2 LLC⁽³⁾
Stock Option (right to buy)	12/05/2019	12/05/2024	Common Stock	3,720	$1.35	I	LH MA 2 LLC⁽³⁾
Stock Option (right to buy)	12/24/2019	12/24/2024	Common Stock	3,720	$0.62	I	LH MA 2 LLC⁽³⁾
Stock Option (right to buy)	01/17/2020	01/17/2025	Common Stock	7,440	$0.62	I	LH MA 2 LLC⁽³⁾

Explanation of Responses:

1. Jacob Sod is the Manager of LH MA 2 LLC and beneficially owns 5,980,657 shares of common stock held by LH MA 2 LLC.

2. Jacob Sod is the Manager of Crestview 360 Holdings LLC and beneficially owns 306,868 shares of common stock held by Crestview 360 Holdings LLC.

3. Jacob Sod is the Manager of LHA MA 2 LLC and beneficially owns the options and underlying shares held by LHA MA 2 LLC.

	/s/ Jacob Sod	09/14/2021
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.