0001567619-21-017151.txt : 20210915 0001567619-21-017151.hdr.sgml : 20210915 20210915164917 ACCESSION NUMBER: 0001567619-21-017151 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210914 FILED AS OF DATE: 20210915 DATE AS OF CHANGE: 20210915 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Geisler Anthony CENTRAL INDEX KEY: 0001870549 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40638 FILM NUMBER: 211255837 MAIL ADDRESS: STREET 1: C/O XPONENTIAL FITNESS, INC. STREET 2: 17877 VON KARMAN AVE, SUITE 100 CITY: IRVINE STATE: CA ZIP: 92614 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xponential Fitness, Inc. CENTRAL INDEX KEY: 0001802156 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990] IRS NUMBER: 844395129 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 17877 VON KARMAN AVE STREET 2: SUITE 100 CITY: IRVINE STATE: CA ZIP: 92614 BUSINESS PHONE: 6507522078 MAIL ADDRESS: STREET 1: 17877 VON KARMAN AVE STREET 2: SUITE 100 CITY: IRVINE STATE: CA ZIP: 92614 4 1 doc1.xml FORM 4 X0306 4 2021-09-14 0 0001802156 Xponential Fitness, Inc. XPOF 0001870549 Geisler Anthony C/O XPONENTIAL FITNESS, INC. 17877 VON KARMAN AVE., SUITE 100 IRVINE CA 92614 1 1 1 0 Chief Executive Officer Class A Common Stock 2021-09-14 4 P 0 18501 10.8593 A 18501 I The Anthony Geisler Trust U/A Dated 05/17/2011 Class A Common Stock 83300 I LAG Fit, Inc. Shares are owned directly by the Anthony Geisler Trust U/A Dated 05/17/2011 and indirectly by Anthony Geisler as trustee of the trust. LAG Fit, Inc. is wholly owned by Mr. Geisler. Mr. Geisler has reported sole investment and dispositive power over the shares held by LAG Fit, Inc. /s/ John Meloun, as Attorney-in-Fact, for Anthony Geisler 2021-09-15