0001493152-22-025151.txt : 20220906 0001493152-22-025151.hdr.sgml : 20220906 20220906171045 ACCESSION NUMBER: 0001493152-22-025151 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220906 FILED AS OF DATE: 20220906 DATE AS OF CHANGE: 20220906 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: North John F CENTRAL INDEX KEY: 0001506447 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38424 FILM NUMBER: 221229025 MAIL ADDRESS: STREET 1: 150 N. BARTLETT STREET CITY: MEDFORD STATE: OR ZIP: 97501 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lazydays Holdings, Inc. CENTRAL INDEX KEY: 0001721741 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4042 PARK OAKS BLVD STREET 2: SUITE 350 CITY: TAMPA STATE: FL ZIP: 33610 BUSINESS PHONE: 813-246-4999 MAIL ADDRESS: STREET 1: 4042 PARK OAKS BLVD STREET 2: SUITE 350 CITY: TAMPA STATE: FL ZIP: 33610 FORMER COMPANY: FORMER CONFORMED NAME: Andina II Holdco Corp. DATE OF NAME CHANGE: 20171103 4 1 ownership.xml X0306 4 2022-09-06 0 0001721741 Lazydays Holdings, Inc. LAZY 0001506447 North John F C/O LAZYDAYS HOLDINGS, INC. 4042 PARK OAKS BLVD., SUITE 350 TAMPA FL 33610 1 1 0 0 Chief Executive Officer Restricted Stock Units 2022-09-06 4 A 0 105308 0 A Common Stock 105308 105308 D Each Restricted Stock Unit represents a contingent right to receive one share of the issuer's Common Stock. The Restricted Stock Units vest as follows: 35,103 on September 6, 2023, 35,103 on September 6, 2024 and 35,102 on September 6, 2025. /s/ Nicholas J. Tomashot, as attorney-in-fact for John North 2022-09-06