0000950170-23-052394.txt : 20231006 0000950170-23-052394.hdr.sgml : 20231006 20231006160504 ACCESSION NUMBER: 0000950170-23-052394 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231004 FILED AS OF DATE: 20231006 DATE AS OF CHANGE: 20231006 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Isaacman Jared CENTRAL INDEX KEY: 0001805608 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39313 FILM NUMBER: 231314239 MAIL ADDRESS: STREET 1: C/O SHIFT4 PAYMENTS, INC. STREET 2: 2202 N. IRVING STREET CITY: ALLENTOWN STATE: PA ZIP: 18109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Shift4 Payments, Inc. CENTRAL INDEX KEY: 0001794669 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2202 NORTH IRVING STREET CITY: ALLENTOWN STATE: PA ZIP: 18109 BUSINESS PHONE: 888.276.2108 X1220 MAIL ADDRESS: STREET 1: 2202 NORTH IRVING STREET CITY: ALLENTOWN STATE: PA ZIP: 18109 4 1 ownership.xml 4 X0508 4 2023-10-04 0001794669 Shift4 Payments, Inc. FOUR 0001805608 Isaacman Jared 2202 N. IRVING ST. ALLENTOWN PA 18109 true true true false Chairman & CEO false Class C Common Stock 2023-10-04 4 G false 47232 0.00 D 1540219 I See footnote The transaction reported shows the Reporting Person's charitable gift of 47,232 shares of the Issuer's Class A common stock to St. Luke's Health Network, Inc. d/b/a/ St. Luke's University Health Network (the "Donee") (and the simultaneous cancelation of the same number of shares of the Issuer's Class C Common stock). Per the donation agreement between the Reporting Person and the Donee, the Donee is restricted from any sale of the shares for one year. Securities held of record by Rook Holdings, Inc. ("Rook"). The Reporting Person, Mr. Isaacman, is the sole stockholder of Rook and therefore may be deemed to have beneficial ownership with respect to such securities. /s/ Jordan Frankel, Attorney-in-Fact for Jared Isaacman 2023-10-06