0001493152-21-029110.txt : 20211117 0001493152-21-029110.hdr.sgml : 20211117 20211117160024 ACCESSION NUMBER: 0001493152-21-029110 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211116 FILED AS OF DATE: 20211117 DATE AS OF CHANGE: 20211117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEVINE JACK CENTRAL INDEX KEY: 0001124852 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40809 FILM NUMBER: 211420542 MAIL ADDRESS: STREET 1: C/O BLINK CHARGING CO. STREET 2: 407 LINCOLN ROAD, SUITE 704 CITY: MIAMI BEACH STATE: FL ZIP: 33139 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: 2125 BISCAYNE BLVD STREET 2: #309 CITY: MIAMI STATE: FL ZIP: 33137 BUSINESS PHONE: 305-791-1169 MAIL ADDRESS: STREET 1: 2125 BISCAYNE BLVD STREET 2: #309 CITY: MIAMI STATE: FL ZIP: 33137 4 1 ownership.xml X0306 4 2021-11-16 0 0001817004 EzFill Holdings Inc EZFL 0001124852 LEVINE JACK C/O EZFILL HOLDINGS INC. 2125 BISCAYNE BLVD, #309 MIAMI FL 33137 1 0 0 0 Common Stock 2021-11-16 4 P 0 40000 2.71 A 73763 D Common Stock 186010 I Cameo Life Sciences Investments LLC The 40,000 shares the Reporting Person purchased on November 16, 2021 are held by Jack Levine and Susan Levine JTWROS, a joint tenant account of the Reporting Person and his wife. Jack Levine is the Manager of Cameo Life Sciences Investments LLC and beneficially owns 186,010 shares of common stock, which are held by Cameo Life Sciences Investments, LLC. /s/ Jack Levine 2021-11-17