0001712923-21-000029.txt : 20210317 0001712923-21-000029.hdr.sgml : 20210317 20210317165200 ACCESSION NUMBER: 0001712923-21-000029 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210315 FILED AS OF DATE: 20210317 DATE AS OF CHANGE: 20210317 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kaliban Timothy Daniel CENTRAL INDEX KEY: 0001741126 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38506 FILM NUMBER: 21751186 MAIL ADDRESS: STREET 1: 5565 GLENRIDGE CONNECTOR, SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30342 FORMER NAME: FORMER CONFORMED NAME: Kaliban Timothy Daniel Scott DATE OF NAME CHANGE: 20180517 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GreenSky, Inc. CENTRAL INDEX KEY: 0001712923 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 822135346 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5565 GLENRIDGE CONNECTOR STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30342 BUSINESS PHONE: 678-264-6105 MAIL ADDRESS: STREET 1: 5565 GLENRIDGE CONNECTOR STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30342 4 1 wf-form4_161601426784064.xml FORM 4 X0306 4 2021-03-15 0 0001712923 GreenSky, Inc. GSKY 0001741126 Kaliban Timothy Daniel 5565 GLENRIDGE CONNECTOR, SUITE 700 ATLANTA GA 30342 0 1 0 0 President, Chief Risk Officer Class A common stock 2021-03-15 4 A 0 117404 0 A 1624059 D Class B common stock 956982.67 D Class B common stock 116547.33 I By Kaliban 2014, LLC Holdco Units Class A common stock 956982.67 956982.67 D Holdco Units Class A common stock 116547.33 116547.33 I By Kaliban 2014, LLC Grant of restricted stock, which will vest in four equal installments on March 15, 2022, March 15, 2023, March 15, 2024, and March 15, 2025. The Class B common stock entitles holders to ten votes per share; votes as a single class with the Class A common stock, has no economic rights, and is subject to forfeiture upon exchange of the Reporting Person's Holdco Units as described below. Mr. Kaliban is the sole member and manager of Kaliban 2014, LLC. Pursuant to the Exchange Agreement, dated May 23, 2018, by and among the Issuer, GreenSky Holdings, LLC ("GS Holdings") and the members of GS Holdings, the membership interests of GS Holdings (the "Holdco Units") may be exchanged by the Reporting Person (with automatic cancellation of an equal number of shares of Class B common stock) for shares of Class A common stock on a one-for-one basis, subject to customary adjustments for stock splits, stock dividends, reclassifications and other similar transactions, stock repurchases and other reinvestments of excess cash, or for cash (based on the market price of the shares of Class A common stock), at the Issuer's option. /s/ Steven Fox, as attorney-in-fact 2021-03-17