Jacob Sod - Sep 14, 2021 Form 3 Insider Report for EzFill Holdings Inc (EZFL)

Role
10%+ Owner
Signature
/s/ Jacob Sod
Stock symbol
EZFL
Transactions as of
Sep 14, 2021
Transactions value $
$0
Form type
3
Date filed
9/14/2021, 09:37 PM
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding EZFL Common Stock 6.29M Sep 14, 2021 LH MA 2 LLC and Crestview 360 Holdings LLC F1, F2

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding EZFL Stock Option (right to buy) Sep 14, 2021 Common Stock 7.44K $1.35 LH MA 2 LLC F3
holding EZFL Stock Option (right to buy) Sep 14, 2021 Common Stock 7.44K $1.35 LH MA 2 LLC F3
holding EZFL Stock Option (right to buy) Sep 14, 2021 Common Stock 7.44K $1.35 LH MA 2 LLC F3
holding EZFL Stock Option (right to buy) Sep 14, 2021 Common Stock 3.72K $1.35 LH MA 2 LLC F3
holding EZFL Stock Option (right to buy) Sep 14, 2021 Common Stock 3.72K $0.62 LH MA 2 LLC F3
holding EZFL Stock Option (right to buy) Sep 14, 2021 Common Stock 7.44K $0.62 LH MA 2 LLC F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Jacob Sod is the Manager of LH MA 2 LLC and beneficially owns 5,980,657 shares of common stock held by LH MA 2 LLC.
F2 Jacob Sod is the Manager of Crestview 360 Holdings LLC and beneficially owns 306,868 shares of common stock held by Crestview 360 Holdings LLC.
F3 Jacob Sod is the Manager of LHA MA 2 LLC and beneficially owns the options and underlying shares held by LHA MA 2 LLC.