0001209191-21-070367.txt : 20211217 0001209191-21-070367.hdr.sgml : 20211217 20211217174545 ACCESSION NUMBER: 0001209191-21-070367 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211215 FILED AS OF DATE: 20211217 DATE AS OF CHANGE: 20211217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HENRY DANIEL R CENTRAL INDEX KEY: 0001253706 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34819 FILM NUMBER: 211502915 MAIL ADDRESS: STREET 1: 13160 BIRCH CITY: OVERLAND PARK STATE: KS ZIP: 66211 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: 114 W 7TH STREET SUITE 240 CITY: AUSTIN STATE: TX ZIP: 78701 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 2021-12-15 0 0001386278 GREEN DOT CORP GDOT 0001253706 HENRY DANIEL R 3465 EAST FOOTHILL BOULEVARD PASADENA CA 91107 1 1 0 0 CEO and President Class A Common Stock 2021-12-15 4 F 0 15853 35.37 D 289118 D Represents shares of Class A Common Stock that have been withheld by the issuer to satisfy its income tax withholding and remittance obligations in connection with the net settlement of the PRSUs, based on a price of $35.37 per share, which represented the closing price of the issuer's Class A Common Stock on December 15, 2021, and does not represent a sale by the reporting person. Includes 156 shares acquired under the issuer's employee stock purchase plan on November 14, 2021. /s/ Kristen Juhan as attorney-in-fact for Daniel Henry 2021-12-17