SEC Form 4 · accession 0001493152-18-003612
Lazydays Holdings, Inc. · LAZY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
B. Luke Weil
Director
Period of report
Mar 15, 2018
Accepted (ET)
Mar 19, 2018 · 8:46 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001721741
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 15, 2018 | A | 10,571 | $0.00 | A | 411,663 | D | |
| Common StockF2 | holding | — | — | — | 29,000 | I | See Note |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (right to buy)F1,F3 | $11.50 | Mar 15, 2018 | A | 37,000 | A | — | Mar 15, 2023 | Common Stock | 37,000 | 37,000 | D |
Explanation of responses
- F1These securities were issued to the Reporting Person pursuant to the Agreement and Plan of Merger, dated as of October 27, 2017, by and among Andino II Holdco Corp (the predecessor to the Issuer), Andina Acquisition Corp. II, Andina II Merger Sub, Inc., Lazy Days' R.V. Center, Inc. and the other signatories party thereto.
- F2These Shares are owned by a limited liability company controlled by the Reporting Person.
- F3Immediately exercisable.