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