0001493152-23-010871.txt : 20230404 0001493152-23-010871.hdr.sgml : 20230404 20230404172018 ACCESSION NUMBER: 0001493152-23-010871 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230331 FILED AS OF DATE: 20230404 DATE AS OF CHANGE: 20230404 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McConnell Michael Joel CENTRAL INDEX KEY: 0001876876 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40809 FILM NUMBER: 23799464 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 X0407 4 2023-03-31 0 0001817004 EzFill Holdings Inc EZFL 0001876876 McConnell Michael Joel C/O EZFILL HOLDINGS, INC. 2999 NE 191ST STREET, SUITE 500 AVENTURA FL 33180 1 1 0 0 Chief Executive Officer 0 Vested stock option 0.29 2023-03-31 4 A 0 438596 0.00 A 2028-03-31 Common Stock 438596 606530 D The vested stock options were granted on March 31, 2023 based on a closing price of $0.29 pursuant to the EzFill Holdings, Inc. 2022 Equity Incentive Plan and Mr. McConnell's employment agreement, which entitles him to $50,000 per quarter in stock options in lieu of salary forgone. The number of shares was determined using the Black-Scholes model. /s/ Michael McConnell 2023-04-04