0001493152-23-015411.txt : 20230504
0001493152-23-015411.hdr.sgml : 20230504
20230504133350
ACCESSION NUMBER: 0001493152-23-015411
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230419
FILED AS OF DATE: 20230504
DATE AS OF CHANGE: 20230504
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Vaknin Avishai
CENTRAL INDEX KEY: 0001976403
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40809
FILM NUMBER: 23887781
MAIL ADDRESS:
STREET 1: 2999 NE 191ST STREET
CITY: AVENTURA
STATE: FL
ZIP: 33180
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
2023-04-19
0
0001817004
EzFill Holdings Inc
EZFL
0001976403
Vaknin Avishai
C/O EZFILL HOLDINGS, INC.,
2999 NE 191ST STREET
AVENTURA
FL
33180
0
1
0
0
Chief Technology Officer
0
Restricted Stock Units
2023-04-19
4
A
0
2600000
0
A
2600000
D
The restricted stock units were granted on April 19, 2023 pursuant to Mr. Vaknin's employment agreement with the Company, which was filed on April 25, 2023 in the Company's Current Report on Form 8-K in conjunction with his appointment as the Company's Chief Technology Officer. Pursuant to his employment agreement, in lieu of a cash salary, Mr. Vaknin will be entitled to Performance Based Restricted Stock Units ("PBRS"). The amount of PBRS issued to Mr. Vaknin will be up to 2,600,000 shares of the Company's restricted common stock, which issuance is subject to the availability of such shares under the EzFill Holdings, Inc. 2023 Equity Incentive Plan. Vesting of the PBRS will be based on achievement of the performance indicators ("Performance Indicators") identified in Schedule I of the employment agreement.
/s/ Avishai Vaknin
2023-05-04