0001493152-24-033346.txt : 20240820 0001493152-24-033346.hdr.sgml : 20240820 20240820212909 ACCESSION NUMBER: 0001493152-24-033346 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240816 FILED AS OF DATE: 20240820 DATE AS OF CHANGE: 20240820 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FARKAS MICHAEL D CENTRAL INDEX KEY: 0001128728 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40809 FILM NUMBER: 241227011 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EzFill Holdings Inc CENTRAL INDEX KEY: 0001817004 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500] ORGANIZATION NAME: 07 Trade & Services 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 2024-08-16 0 0001817004 EzFill Holdings Inc EZFL 0001128728 FARKAS MICHAEL D C/O EZFILL HOLDINGS, INC. 67 NW 183RD STREET MIAMI FL 33139 0 0 1 0 0 Common Stock, par value $0.0001 per share 2024-08-16 4 J 0 3525341 2.78 A 4876908 I NextNRG Holding Corp. Series B Convertible Preferred Stock 1.932 2024-08-16 4 P 0 140000 10.00 A Common Stock 724638 140000 I NextNRG Holding Corp. On August 16, 2024, NextNRG Holding Corp. ("NextNRG") exchanged promissory notes previously issued by the Issuer to NextNRG in the aggregate principal amount of $9,800,449 for 3,525,341 shares of the Issuer's common stock pursuant to an Exchange Agreement entered into between NextNRG and the Issuer dated August 16, 2024. NextNRG is an entity controlled by the reporting person, and the reported securities may be deemed to be indirectly beneficially owned by the reporting person. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that such person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose. Shares are convertible following approval of the Issuer's stockholders of the issuance of the common stock issuable upon conversion of the preferred stock and the approval of Nasdaq or other securities exchange where the common stock is listed for public trading. The number of shares is subject to proportional adjustment in the event of a stock split, stock dividend, stock combination, recapitalization or other similar transaction. /s/ Michael D. Farkas 2024-08-20