0001493152-18-016157.txt : 20181114 0001493152-18-016157.hdr.sgml : 20181114 20181114164518 ACCESSION NUMBER: 0001493152-18-016157 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181112 FILED AS OF DATE: 20181114 DATE AS OF CHANGE: 20181114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TOMASHOT NICHOLAS J CENTRAL INDEX KEY: 0001230539 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38424 FILM NUMBER: 181184676 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lazydays Holdings, Inc. CENTRAL INDEX KEY: 0001721741 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 250 W 57TH STREET STREET 2: SUITE 2223 CITY: NEW YORK STATE: NY ZIP: 10107 BUSINESS PHONE: 646-565-3861 MAIL ADDRESS: STREET 1: 250 W 57TH STREET STREET 2: SUITE 2223 CITY: NEW YORK STATE: NY ZIP: 10107 FORMER COMPANY: FORMER CONFORMED NAME: Andina II Holdco Corp. DATE OF NAME CHANGE: 20171103 4 1 ownership.xml X0306 4 2018-11-12 0 0001721741 Lazydays Holdings, Inc. LAZY 0001230539 TOMASHOT NICHOLAS J C/O LAZYDAYS HOLDINGS, INC. 6130 LAZY DAYS BOULEVARD SEFFNER FL 33584 0 1 0 0 Chief Financial Officer Common Stock 2018-11-12 4 P 0 3831 5.2432 A 3831 D /s/ Nicholas Tomashot 2018-11-14