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