0001493152-24-007737.txt : 20240223 0001493152-24-007737.hdr.sgml : 20240223 20240223185106 ACCESSION NUMBER: 0001493152-24-007737 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240221 FILED AS OF DATE: 20240223 DATE AS OF CHANGE: 20240223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: North John F CENTRAL INDEX KEY: 0001506447 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38424 FILM NUMBER: 24673137 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] ORGANIZATION NAME: 07 Trade & Services 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 X0508 4 2024-02-21 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 0 Common Stock 2024-02-21 4 M 0 7789 0 A 46345 D Common Stock 2024-02-21 4 F 0 2309 4.14 D 44036 D Restricted Stock Units 2024-02-21 4 M 0 7789 0 D Common Stock 7789 15815 D Each restricted stock unit represents a contingent right to receive one share of the Issuer's Common Stock. The original 23,604 Restricted Stock Units vest as follows: 7,789 on February 21, 2024, 7,789 on February 21, 2025 and 8,026 on February 21, 2026. /s/ Kelly Porter, Attorney-in-Fact for John North 2024-02-23