0001493152-22-002101.txt : 20220124 0001493152-22-002101.hdr.sgml : 20220124 20220124163232 ACCESSION NUMBER: 0001493152-22-002101 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220120 FILED AS OF DATE: 20220124 DATE AS OF CHANGE: 20220124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Levine Arthur CENTRAL INDEX KEY: 0001351380 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40809 FILM NUMBER: 22549780 MAIL ADDRESS: STREET 1: 19950 WEST COUNTRY CLUB DRIVE, SUITE 800 CITY: AVENTURA STATE: FL ZIP: 33180 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EzFill Holdings Inc CENTRAL INDEX KEY: 0001817004 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500] IRS NUMBER: 834260623 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2125 BISCAYNE BLVD STREET 2: #309 CITY: MIAMI STATE: FL ZIP: 33137 BUSINESS PHONE: 305-791-1169 MAIL ADDRESS: STREET 1: 2125 BISCAYNE BLVD STREET 2: #309 CITY: MIAMI STATE: FL ZIP: 33137 4 1 ownership.xml X0306 4 2022-01-20 0 0001817004 EzFill Holdings Inc EZFL 0001351380 Levine Arthur C/O EZFILL HOLDINGS, INC. 2125 BISCAYNE BLVD MIAMI FL 33137 0 1 0 0 Chief Financial Officer Common Stock 2022-01-20 4 A 0 22321 A 48894 D Stock Option 1.26 2022-01-20 4 A 0 125951 0.00 A 2030-01-20 Common Stock 125951 125951 D On January 20, 2022, the Reporting Person was awarded $28,125 of restricted common stock pursuant to the EzFill 2020 Incentive Compensation Plan, with the common stock valued at the closing price on January 20, 2022 ($1.26 per share). The shares vest one year from the date of the grant. The Options were granted pursuant to the EzFill 2020 Incentive Compensation Plan and vest 1/3 on the first anniversary of the grant, 1/3 on the second anniversary of the grant and 1/3 on the third anniversary of the grant. /s/ Arthur Levine 2022-01-24