SEC Form 4 · accession 0001193125-26-392085
Dave Inc./DE · DAVE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kyle Beilman
Officer — CFO and COO and Secretary
Period of report
Sep 11, 2026
Accepted (ET)
Sep 15, 2026 · 4:58 pm EDT
Rule 10b5-1 plan
box not checked
Issuer CIK
0001841408
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Variable Prepaid Forward Contract (obligation to sell)F1,F2,F3 | — | Sep 11, 2026 | J | 40,000 | A | — | — | Class A Common Stock | 40,000 | 40,000 | D |
Explanation of responses
- F1On September 11, 2026, the Reporting Person entered into a variable prepaid forward contract with an unaffiliated counterparty. The contract obligates the Reporting Person to deliver shares of Dave Inc. (the "Issuer") Class A Common Stock or, at the Reporting Person's election subject to certain conditions, settle the contract in cash, on a settlement date on or about June 15, 2028 (the "Maturity Date"). In exchange, the Reporting Person will receive an upfront cash payment of $10.8 million. The Reporting Person pledged 40,000 shares of the Issuer's Class A Common Stock (the "Subject Shares") to secure his obligations under the contract. The Reporting Person will retain all voting, dividend and other rights in the Subject Shares during the term of the pledge.
- F2If the Reporting Person does not elect to settle the contract in cash, the number of shares of the Issuer's Class A Common Stock that may be delivered by the Reporting Person following the Maturity Date will generally be determined as follows: (a) if the closing price of shares of the Issuer's Class A Common Stock prior to the Maturity Date (the "Settlement Price") is less than $490.46 (the "Maximum Price") but greater than $297.78 (the "Minimum Price"), the Reporting Person will deliver a number of shares of the Issuer's Class A Common Stock equal to the Subject Shares multiplied by a ratio equal to the Minimum Price divided by the Settlement Price;
- F3[Continued from footnote 2] (b) if the Settlement Price is equal to or greater than the Maximum Price as of the Maturity Date, the Reporting Person will deliver a number of shares of the Issuer's Class A Common Stock equal to the Subject Shares multiplied by a ratio equal to a fraction with a numerator equal to the sum of (A) the Minimum Price and (B) the excess, if any, of the Settlement Price over the Maximum Price, and a denominator equal to the Settlement Price; and (c) if the Settlement Price is equal to or less than the Minimum Price as of the Maturity Date, the Reporting Person will deliver a number of shares of the Issuer's Class A Common Stock equal to the Subject Shares.