0001667731-23-000374.txt : 20230815
0001667731-23-000374.hdr.sgml : 20230815
20230815190618
ACCESSION NUMBER: 0001667731-23-000374
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230811
FILED AS OF DATE: 20230815
DATE AS OF CHANGE: 20230815
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Breon Eric
CENTRAL INDEX KEY: 0001890272
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41130
FILM NUMBER: 231176109
MAIL ADDRESS:
STREET 1: 201 SW DOGWOOD LN
CITY: WHITE SALMON
STATE: WA
ZIP: 98672
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mossytree Inc.
CENTRAL INDEX KEY: 0001895949
STATE OF INCORPORATION: OR
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41130
FILM NUMBER: 231176110
BUSINESS ADDRESS:
STREET 1: 201 SW DOGWOOD LN
CITY: WHITE SALMON
STATE: WA
ZIP: 98672
BUSINESS PHONE: 208-791-1255
MAIL ADDRESS:
STREET 1: 201 SW DOGWOOD LN
CITY: WHITE SALMON
STATE: WA
ZIP: 98672
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Vacasa, Inc.
CENTRAL INDEX KEY: 0001874944
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 850 NW 13TH AVENUE
CITY: PORTLAND
STATE: OR
ZIP: 097209
BUSINESS PHONE: (800) 544-0300
MAIL ADDRESS:
STREET 1: 850 NW 13TH AVENUE
CITY: PORTLAND
STATE: OR
ZIP: 097209
4
1
s61223mossytreereporting.xml
X0508
4
2023-08-11
0
0001874944
Vacasa, Inc.
VCSA
0001895949
Mossytree Inc.
201 SW DOGWOOD LN
WHITE SALMON
WA
98672
0
0
1
0
0001890272
Breon Eric
201 SW DOGWOOD LN
WHITE SALMON
WA
98672
0
0
1
0
0
Class A Common Stock
2023-08-11
4
S
0
100000
.66
D
368938
I
Held through Mossytree Inc.
Class A Common Stock
2023-08-14
4
S
0
100000
.62
D
268338
I
Held through Mossytree Inc.
Eric Breon is the President of Mossytree Inc. As a result, Mr. Breon may be deemed to share beneficial ownership of the shares held directly by Mossytree Inc.
/s/ Charles Bolland
2023-08-15