0001493152-21-027721.txt : 20211109 0001493152-21-027721.hdr.sgml : 20211109 20211109213437 ACCESSION NUMBER: 0001493152-21-027721 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211105 FILED AS OF DATE: 20211109 DATE AS OF CHANGE: 20211109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Weiss Allen R CENTRAL INDEX KEY: 0001534426 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40809 FILM NUMBER: 211394152 MAIL ADDRESS: STREET 1: C/O DICK'S SPORTING GOODS, INC. STREET 2: 345 COURT STREET CITY: CORAOPOLIS STATE: PA ZIP: 15108 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EzFill Holdings Inc CENTRAL INDEX KEY: 0001817004 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500] IRS NUMBER: 834260623 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2125 BISCAYNE BLVD STREET 2: #309 CITY: MIAMI STATE: FL ZIP: 33137 BUSINESS PHONE: 305-791-1169 MAIL ADDRESS: STREET 1: 2125 BISCAYNE BLVD STREET 2: #309 CITY: MIAMI STATE: FL ZIP: 33137 4 1 ownership.xml X0306 4 2021-11-05 0 0001817004 EzFill Holdings Inc EZFL 0001534426 Weiss Allen R C/O EZFILL HOLDINGS, INC. 2125 BISCAYNE BLVD, #309 MIAMI FL 33137 1 0 0 0 Common Stock 2021-11-05 4 A 0 42662 2.93 A 55948 D On 11/05/2021, Mr. Weiss was awarded $125,000 worth of restricted common stock pursuant to the EzFill 2020 Incentive Compensation Plan, with the common stock valued at the closing price on 11/04/2021 ($2.93 per share). These restricted shares of common stock will vest at the Company's next annual shareholders' meeting only if Mr. Weiss remains a member of the Company's board of directors until such meeting. /s/ Allen Weiss 2021-11-09