Ownership Submission
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FORM 4/A
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Check this box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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OMB APPROVAL
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OMB Number:3235-0287Expires:January 31, 2005Estimated average burden hours per response...0.5
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1. Name and Address of Reporting Person *
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FARKAS MICHAEL D
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2. Issuer Name and Ticker or Trading Symbol
EzFill Holdings Inc [EZFL]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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_____ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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(Last)
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(First)
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(Middle)
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C/O EZFILL HOLDINGS, INC. , 67 NW 183RD STREET
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3. Date of Earliest Transaction (Month/Day/Year)
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4. If Amendment, Date Original Filed(Month/Day/Year)
2024-05-31
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6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
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2. Transaction Date (Month/Day/Year)
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2A. Deemed Execution Date, if any (Month/Day/Year)
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3. Transaction Code
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4. Securities Acquired (A) or Disposed of (D)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
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6. Ownership Form: Direct (D) or Indirect (I)
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7. Nature of Indirect Beneficial Ownership
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date (Month/Day/Year)
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3A. Deemed Execution Date, if any (Month/Day/Year)
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4. Transaction Code
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
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8. Price of Derivative Security
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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11. Nature of Indirect Beneficial Ownership
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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FARKAS MICHAEL D
C/O EZFILL HOLDINGS, INC.
67 NW 183RD STREET
MIAMI, FL33139
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X
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Signatures
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/s/ Michael D. Farkas
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2024-07-23
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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(1)
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The Form 4 filed by the Reporting Person on May 31, 2024 is hereby amended to change the Transaction Code from "S" to "J" and delete the number and price of shares disposed of as it relates to 106,836 shares of the Issuer's common stock (the "Reported Transaction") as the agreement between NextNRG Holding Corp. and Stat-EI Inc. and its shareholders pursuant to which these shares were initially transferred was deemed to be null and void ab initio. Consequently, there was no disposition of the 106,836 shares of the Issuer's common stock by the Reporting Person and the Amount of Securities beneficially owned by the Reporting Person following the Reported Transaction was increased by 106,836 from the previously reported 1,234,731 shares to 1,341,567 shares.
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(2)
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The amounts reported as the "Amount of Securities Beneficially Owned Following Reported Transactions" on the Reporting Person's Form 4 filed with the SEC on June 7, 2024 is hereby deemed amended to increase such amounts by 106,836 shares.
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(3)
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The Reporting Person is the Chief Executive Officer and Chairman of NextNRG Holding Corp., and beneficially owns 343,886 shares of common stock held by NextNRG Holding Corp.
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
EzFill Holdings Inc.