0001493152-22-003339.txt : 20220207
0001493152-22-003339.hdr.sgml : 20220207
20220207110838
ACCESSION NUMBER: 0001493152-22-003339
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220204
FILED AS OF DATE: 20220207
DATE AS OF CHANGE: 20220207
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HANREHAN Cheryl Edith
CENTRAL INDEX KEY: 0001876821
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40809
FILM NUMBER: 22596126
MAIL ADDRESS:
STREET 1: 2125 BISCAYNE BLVD,
STREET 2: STE. 309
CITY: MIAMI
STATE: FL
ZIP: 33137
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: EzFill Holdings Inc
CENTRAL INDEX KEY: 0001817004
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500]
IRS NUMBER: 834260623
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2125 BISCAYNE BLVD
STREET 2: #309
CITY: MIAMI
STATE: FL
ZIP: 33137
BUSINESS PHONE: 305-791-1169
MAIL ADDRESS:
STREET 1: 2125 BISCAYNE BLVD
STREET 2: #309
CITY: MIAMI
STATE: FL
ZIP: 33137
4
1
ownership.xml
X0306
4
2022-02-04
0
0001817004
EzFill Holdings Inc
EZFL
0001876821
HANREHAN Cheryl Edith
C/O EZFILL HOLDINGS, INC.
2125 BISCAYNE BLVD, #309
MIAMI
FL
33137
1
0
0
0
Common Stock
2022-02-04
4
A
0
22321
A
48894
D
Options
1.26
2022-02-04
4
A
0
125951
0
A
2022-02-04
2030-02-04
Common Stock
125951
125951
D
Granted pursuant to a Separation Agreement between the Issuer and the Reporting Person. The Reporting Person was granted $28,125 of restricted Common Stock pursuant to the EzFill Holdings, Inc. 2020 Incentive Compensation Plan with the common stock valued at the closing price on January 20, 2022 ($ 1.26 per share). The shares vest immediately.
The Options were granted pursuant to the EzFill 2020 Incentive Compensation Plan and vest immediately.
/s/ Cheryl Hanrehan
2022-02-07