-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DXw+jJVebtN1vjZpYsC/pFzupUGFyJKCo0UZNfh4sQfruvb/X0Aaq9fI3MEGm4rv T67LHf3xjNOIBcn1D8DKSg== 0001209191-10-040182.txt : 20100729 0001209191-10-040182.hdr.sgml : 20100729 20100729203302 ACCESSION NUMBER: 0001209191-10-040182 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100727 FILED AS OF DATE: 20100729 DATE AS OF CHANGE: 20100729 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Keatley John L CENTRAL INDEX KEY: 0001494442 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34819 FILM NUMBER: 10979255 MAIL ADDRESS: STREET 1: 605 E. HUNTINGTON DRIVE, SUITE 205 CITY: MONROVIA STATE: CA ZIP: 91016 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 BUSINESS ADDRESS: STREET 1: 605 E HUNTINGTON DRIVE STREET 2: SUITE 205 CITY: MONROVIA STATE: CA ZIP: 91016 BUSINESS PHONE: 6267753400 MAIL ADDRESS: STREET 1: 605 E HUNTINGTON DRIVE STREET 2: SUITE 205 CITY: MONROVIA STATE: CA ZIP: 91016 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2010-07-27 0 0001386278 GREEN DOT CORP GDOT 0001494442 Keatley John L 605 E. HUNTINGTON DRIVE, SUITE 205 MONROVIA CA 91016 0 1 0 0 Chief Financial Officer Class A Common Stock 2010-07-27 4 C 0 75300 0.00 A 75300 D Class A Common Stock 2010-07-27 4 S 0 75300 33.48 D 0 D Class A Common Stock 0 I By minor children Stock Option (right to buy Class B Common Stock) 4.64 2010-07-27 4 M 0 75300 0.00 D 2018-02-15 Class B Common Stock 75300 214700 D Class B Common Stock 0.00 2010-07-27 4 M 0 75300 0.00 A Class A Common Stock 75300 156700 D Class B Common Stock 0.00 2010-07-27 4 C 0 75300 0.00 D Class A Common Stock 75300 81400 D Class B Common Stock 0.00 Class A Common Stock 6600 6600 I By minor children Options vest as to 1/4 of the shares on August 31, 2008 and then 1/48th monthly thereafter, subject to the reporting person's provision of services to the issuer on each vesting date. The Class B Common Stock is convertible at the holder's option into the issuer's Class A Common Stock on a 1-for-1 basis and has no expiration date. The holder elected to convert the shares of Class B Common Stock into Class A Common Stock, which Class A Common Stock has no exercisable date or expiration date. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. /s/ Lina Davidian as attorney-in-fact for John L. Keatley 2010-07-29 -----END PRIVACY-ENHANCED MESSAGE-----