0001493152-19-007649.txt : 20190516 0001493152-19-007649.hdr.sgml : 20190516 20190516163016 ACCESSION NUMBER: 0001493152-19-007649 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190514 FILED AS OF DATE: 20190516 DATE AS OF CHANGE: 20190516 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: 19832641 MAIL ADDRESS: STREET 1: C/O LAZYDAYS HOLDINGS, INC. STREET 2: 6130 LAZY DAYS BOULEVARD CITY: SEFFNER STATE: FL ZIP: 33584 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 2019-05-14 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 2019-05-14 4 P 0 2000 4.82 A 5831 D /s/ Nicholas Tomashot 2019-05-16