0001712923-21-000026.txt : 20210317
0001712923-21-000026.hdr.sgml : 20210317
20210317165009
ACCESSION NUMBER: 0001712923-21-000026
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210315
FILED AS OF DATE: 20210317
DATE AS OF CHANGE: 20210317
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KELLY DENNIS I
CENTRAL INDEX KEY: 0001192815
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38506
FILM NUMBER: 21751170
MAIL ADDRESS:
STREET 1: 10720 SIKES PL
STREET 2: STE 300
CITY: CHARLOTTE
STATE: NC
ZIP: 28277
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: GreenSky, Inc.
CENTRAL INDEX KEY: 0001712923
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 822135346
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5565 GLENRIDGE CONNECTOR
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30342
BUSINESS PHONE: 678-264-6105
MAIL ADDRESS:
STREET 1: 5565 GLENRIDGE CONNECTOR
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30342
4
1
wf-form4_161601419354072.xml
FORM 4
X0306
4
2021-03-15
0
0001712923
GreenSky, Inc.
GSKY
0001192815
KELLY DENNIS I
5565 GLENRIDGE CONNECTOR, SUITE 700
ATLANTA
GA
30342
0
1
0
0
President, Patient Solutions
Class A common stock
2021-03-15
4
A
0
69064
0
A
244910
D
Class B common stock
268566.94
D
Holdco Units
Class A common stock
268566.94
268566.94
D
Grant of restricted stock, which will vest in four equal installments on March 15, 2022, March 15, 2023, March 15, 2024, and March 15, 2025.
The Class B common stock entitles holders to ten votes per share; votes as a single class with the Class A common stock, has no economic rights, and is subject to forfeiture upon exchange of the Reporting Person's Holdco Units as described below.
Pursuant to the Exchange Agreement, dated May 23, 2018, by and among the Issuer, GreenSky Holdings, LLC ("GS Holdings") and the members of GS Holdings, the membership interests of GS Holdings (the "Holdco Units") may be exchanged by the Reporting Person (with automatic cancellation of an equal number of shares of Class B common stock) for shares of Class A common stock on a one-for-one basis, subject to customary adjustments for stock splits, stock dividends, reclassifications and other similar transactions, stock repurchases and other reinvestments of excess cash, or for cash (based on the market price of the shares of Class A common stock), at the Issuer's option.
/s/ Steven Fox, as attorney-in-fact
2021-03-17