0001209191-19-052594.txt : 20191004 0001209191-19-052594.hdr.sgml : 20191004 20191004181051 ACCESSION NUMBER: 0001209191-19-052594 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191002 FILED AS OF DATE: 20191004 DATE AS OF CHANGE: 20191004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bibelheimer Jason CENTRAL INDEX KEY: 0001771636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34819 FILM NUMBER: 191139372 MAIL ADDRESS: STREET 1: 3465 EAST FOOTHILL BOULEVARD CITY: PASADENA STATE: CA ZIP: 91107 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 2019-10-02 0 0001386278 GREEN DOT CORP GDOT 0001771636 Bibelheimer Jason 3465 EAST FOOTHILL BOULEVARD PASADENA CA 91107 0 1 0 0 Chief Human Resources Officer Class A Common Stock 2019-10-02 4 F 0 5187 23.50 D 46973 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 $23.50 per share, which represented the closing price of the issuer's Class A Common Stock on October 2, 2019, and does not represent a sale by the reporting person. Includes 301 shares acquired under the issuer's employee stock purchase plan on May 14, 2019. /s/ Lina Davidian as attorney-in-fact for Jason Bibelheimer 2019-10-04