0001185185-21-001351.txt : 20210923 0001185185-21-001351.hdr.sgml : 20210923 20210923161351 ACCESSION NUMBER: 0001185185-21-001351 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210602 FILED AS OF DATE: 20210923 DATE AS OF CHANGE: 20210923 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Moghavem Pouya CENTRAL INDEX KEY: 0001876750 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34294 FILM NUMBER: 211272675 MAIL ADDRESS: STREET 1: 3131 CAMINO DEL RIO NORTH STREET 2: SUITE 1400 CITY: SAN DIEGO STATE: CA ZIP: 92108 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GreenBox POS CENTRAL INDEX KEY: 0001419275 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT CONSULTING SERVICES [8742] IRS NUMBER: 000000000 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3131 CAMINO DEL RIO NORTH, SUITE 1400 CITY: SAN DIEGO STATE: CA ZIP: 92108 BUSINESS PHONE: 619-631-8261 MAIL ADDRESS: STREET 1: 3131 CAMINO DEL RIO NORTH, SUITE 1400 CITY: SAN DIEGO STATE: CA ZIP: 92108 FORMER COMPANY: FORMER CONFORMED NAME: GreenBox POS, LLC DATE OF NAME CHANGE: 20180613 FORMER COMPANY: FORMER CONFORMED NAME: ASAP Expo, Inc. DATE OF NAME CHANGE: 20071123 4 1 ownership.xml X0306 4 2021-06-02 0 0001419275 GreenBox POS GBOX 0001876750 Moghavem Pouya 3131 CAMINO DEL RIO NORTH SUITE 1400 SAN DIEGO CA 92108 0 1 0 0 CBDO Common Stock par value $0.001 2021-06-16 4 M 0 246 6.06 A 35041 D Common Stock par value $0.001 2021-06-16 4 M 0 4050 0.42 A 38678 D Common Stock par value $0.001 2021-06-16 4 M 0 6243 0.39 A 40754 D Common Stock par value $0.001 2021-07-06 4 A 0 50000 0.00 A 84344 D Common Stock par value $0.001 2021-08-11 4 A 0 41667 0.00 A 126011 D Stock Options 12.10 2021-06-02 4 A 0 3306 0.00 A 2021-12-01 2031-06-02 Common Stock par value $0.001 3306 34795 D Stock Options 6.06 2021-06-16 4 D 0 413 0.00 D 2021-12-01 2031-06-02 Common Stock par value $0.001 413 34628 D Stock Options 0.42 2021-06-16 4 D 0 4167 0.00 D 2021-12-01 2031-06-02 Common Stock par value $0.001 4167 34511 D Stock Options 0.39 2021-06-16 4 D 0 6410 0.00 D 2021-12-01 2031-06-02 Common Stock par value $0.001 6410 34344 D Mr. Moghavem did a cashless exercise of his 413 stock options. Mr. Moghavem received 246 shares of common stock and surrendered 167 shares of common stock underlying the stock option in payment of the exercise price. Mr. Moghavem did a cashless exercise of his 4,167 stock options. Mr. Moghavem received 4,050 shares of common stock and surrendered 117 shares of common stock underlying the stock option in payment of the exercise price. Mr. Moghavem did a cashless exercise of his 6,410 stock options. Mr. Moghavem received 6,243 shares of common stock and surrendered 167 shares of common stock underlying the stock option in payment of the exercise price. /s/ Pouya Moghavem 2021-09-22