0001493152-21-022755.txt : 20210914
0001493152-21-022755.hdr.sgml : 20210914
20210914213012
ACCESSION NUMBER: 0001493152-21-022755
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210914
FILED AS OF DATE: 20210914
DATE AS OF CHANGE: 20210914
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FARKAS MICHAEL D
CENTRAL INDEX KEY: 0001128728
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40809
FILM NUMBER: 211254000
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
3
1
ownership.xml
X0206
3
2021-09-14
0
0001817004
EzFill Holdings Inc
EZFL
0001128728
FARKAS MICHAEL D
C/O EZFILL HOLDINGS, INC.
2125 BISCAYNE BLVD, #309
MIAMI
FL
33137
0
0
1
0
Common Stock
6740933
I
See Notes
Stock Option (right to buy)
1.35
2019-07-03
2024-07-03
Common Stock
7440
I
Options held by the Farkas Group, Inc. (See Note)
Stock Option (right to buy)
1.35
2019-07-12
2024-07-12
Common Stock
7440
I
Options held by the Farkas Group, Inc. (See Note)
Stock Option (right to buy)
1.35
2019-07-29
2024-07-29
Common Stock
7440
I
Options held by the Farkas Group, Inc. (See Note)
Stock Option (right to buy)
1.35
2019-12-05
2024-12-05
Common Stock
3720
I
Options held by the Farkas Group, Inc. (See Note)
Stock Option (right to buy)
0.62
2019-12-24
2024-12-24
Common Stock
3720
I
Options held by the Farkas Group, Inc. (See Note)
Stock Option (right to buy)
0.62
2020-01-17
2025-01-17
Common Stock
7440
I
Options held by the Farkas Group, Inc. (See Note)
Michael D. Farkas is the President of the Farkas Group, Inc. and beneficially owns 3,378,674 shares of common stock held by the Farkas Group, Inc.
Michael D. Farkas is the Manager of SIF Energy LLC and beneficially owns 3,096,531 shares of common stock held by SIF Energy LLC.
Michael D. Farkas is the Chief Executive Officer of Balance Labs, Inc. and beneficially owns 265,728 shares of common stock held by Balance Labs, Inc.
Michael D. Farkas is the President of the Farkas Group, Inc. and beneficially owns the options and underlying shares held by the Farkas Group, Inc.
/s/ Michael D. Farkas
2021-09-14