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