0001209191-17-055489.txt : 20171003 0001209191-17-055489.hdr.sgml : 20171003 20171003193159 ACCESSION NUMBER: 0001209191-17-055489 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171001 FILED AS OF DATE: 20171003 DATE AS OF CHANGE: 20171003 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shifke Mark L CENTRAL INDEX KEY: 0001497742 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34819 FILM NUMBER: 171119990 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 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3465 E. FOOTHILL BLVD CITY: PASADENA STATE: CA ZIP: 91107 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 2017-10-01 0 0001386278 GREEN DOT CORP GDOT 0001497742 Shifke Mark L 3465 EAST FOOTHILL BOULEVARD PASADENA CA 91107 0 1 0 0 Chief Financial Officer Class A Common Stock 2017-10-01 4 F 0 1396 0.00 D 756179 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 RSUs, based on a price of $49.58 per share, which represented the closing price of the issuer's Class A Common Stock on September 29, 2017, and does not represent a sale by the reporting person. /s/ Lina Davidian as attorney-in-fact for Mark L. Shifke 2017-10-03