0001209191-21-037006.txt : 20210601
0001209191-21-037006.hdr.sgml : 20210601
20210601211516
ACCESSION NUMBER: 0001209191-21-037006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20210527
FILED AS OF DATE: 20210601
DATE AS OF CHANGE: 20210601
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: RICHEY ELLEN
CENTRAL INDEX KEY: 0001222057
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34819
FILM NUMBER: 21987439
MAIL ADDRESS:
STREET 1: C/O VISA INC.
STREET 2: P.O. BOX 8999
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94128-8999
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: GREEN DOT CORP
CENTRAL INDEX KEY: 0001386278
STANDARD INDUSTRIAL CLASSIFICATION: FINANCE SERVICES [6199]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3465 E. FOOTHILL BLVD
CITY: PASADENA
STATE: CA
ZIP: 91107
BUSINESS PHONE: 6267652000
MAIL ADDRESS:
STREET 1: 3465 E. FOOTHILL BLVD
CITY: PASADENA
STATE: CA
ZIP: 91107
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-05-27
0
0001386278
GREEN DOT CORP
GDOT
0001222057
RICHEY ELLEN
C/O 3465 EAST FOOTHILL BOULEVARD
PASADENA
CA
91107
1
0
0
0
Class A Common Stock
2021-05-27
4
A
0
3107
0.00
A
7201
D
Represents shares of Class A Common Stock underlying a restricted stock unit award that will vest as to all underlying shares on the earlier of (i)
the first anniversary of the date of grant or (ii) the date of the 2022 annual stockholders meeting.
Exhibit List Exhibit 24.1: Power of Attorney
/s/ Kristen Juhan as attorney-in-fact for Ellen Richey
2021-06-01
EX-24.4_989387
2
poa.txt
POA DOCUMENT
SECTION 16 REPORTS POWER OF ATTORNEY
The undersigned as a Section 16 reporting person of Green Dot Corporation (the
"Company"), hereby constitutes and appoints Kristina Lockwood, Lina Davidian and
Kristen Juhan, and each of them, the undersigned's true and lawful
attorney-in-fact to:
(1) execute, deliver and file for and on behalf of the undersigned, in the
undersigned's capacity as an officer and/or director of the Company, Forms 3,
4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of
1934, as amended, and the rules and regulations thereunder (the "Exchange Act");
(2) do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable to complete and execute any such Form 3, 4, or 5,
complete and execute any amendment or amendments thereto, and timely file such
form with the United States Securities and Exchange Commission and any stock
exchange or similar authority;
(3) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third
party, including brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such release of
information; and
(4) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this Power of Attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Exchange Act. The undersigned further acknowledges and
agrees that the attorney-in-fact and the Company are relying on written and oral
information provided by the undersigned to complete such forms and the
undersigned is responsible for reviewing the completed forms prior to their
filing. The attorney-in-fact and the Company are not responsible for any errors
or omissions in such filings. The attorney-in-fact and the Company are not
responsible for determining whether or not the transactions reported could be
matched with any other transactions for the purpose of determining liability for
short-swing profits under Section 16(b).
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
Company and the foregoing attorneys-in-fact. This Power of Attorney revokes all
previous powers of attorney with respect to the subject matter of this Power of
Attorney.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 31st day of January, 2021.
/s/ Ellen Richey
Name: Ellen Richey