0001493152-23-039167.txt : 20231102
0001493152-23-039167.hdr.sgml : 20231102
20231102165338
ACCESSION NUMBER: 0001493152-23-039167
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231031
FILED AS OF DATE: 20231102
DATE AS OF CHANGE: 20231102
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Porter Kelly
CENTRAL INDEX KEY: 0001951508
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38424
FILM NUMBER: 231373325
MAIL ADDRESS:
STREET 1: 4042 PARK OAKS BLVD, SUITE 350
CITY: TAMPA
STATE: FL
ZIP: 33610
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
X0508
4
2023-10-31
0
0001721741
Lazydays Holdings, Inc.
LAZY
0001951508
Porter Kelly
C/O LAZYDAYS HOLDINGS, INC.,
4042 PARK OAKS BLVD, SUITE 350
TAMPA
FL
33610
0
1
0
0
Chief Financial Officer
0
Common Stock
2023-10-31
4
M
0
18588
A
18588
D
Common Stock
2023-10-31
4
F
0
4525
6.31
A
14063
D
Restricted Stock Units
2023-10-31
4
M
0
18588
0
D
Common Stock
18588
37174
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: 18,588 on October 31, 2023, 18,587 on October 31, 2024 and 18,587 on October 31, 2025.
Represents net shares issued with 4,525 shares to cover taxes withheld.
Exhibit 24 - Limited Power of Attorney
/s/ Minola Hunt, Attorney-in-Fact for Kelly Porter
2023-11-02