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