# EDGAR Filing Document

**Accession Number:** 0001386278
**File Stem:** 0001209191-23-017684
**Filing Date:** 2023-3
**Character Count:** 7192
**Document Hash:** 927e653ff14b8df0b9c9a3ffb085dc1a
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-017684.hdr.sgml**: 20230309

**ACCESSION NUMBER**: 0001209191-23-017684

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230307

**FILED AS OF DATE**: 20230309

**DATE AS OF CHANGE**: 20230309

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Parikh Amit Lokesh
- **CENTRAL INDEX KEY:** 0001853948

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34819
- **FILM NUMBER:** 23721258

**MAIL ADDRESS:**
- **STREET 1:** 3465 EAST FOOTHILL BOULEVARD
- **CITY:** PASADENA
- **STATE:** CA
- **ZIP:** 91107
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** GREEN DOT CORP
- **CENTRAL INDEX KEY:** 0001386278
- **STANDARD INDUSTRIAL CLASSIFICATION:** FINANCE SERVICES [6199]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 114 W 7TH STREET SUITE 240
- **CITY:** AUSTIN
- **STATE:** TX
- **ZIP:** 78701
- **BUSINESS PHONE:** 6267652000

**MAIL ADDRESS:**
- **STREET 1:** 3465 E. FOOTHILL BLVD
- **CITY:** PASADENA
- **STATE:** CA
- **ZIP:** 91107

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Parikh Amit Lokesh<br><sub>(Last) (First) (Middle)</sub><br>114 W 7TH STREET<br>SUITE 240<br><sub>(Street)</sub><br>AUSTIN, TX 78701<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_EVP, Banking as a Service Div._ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>GREEN DOT CORP [ GDOT ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Class A Common Stock | 2023-03-07 |  | A |  | 9468<sup>(1)</sup> | A | $0.00 | 95191 | D |  |
| Class A Common Stock | 2023-03-07 |  | A |  | 24793<sup>(2)</sup> | A | $0.00 | 119984 | D |  |
| Class A Common Stock | 2023-03-07 |  | F |  | 2458<sup>(3)</sup> | D | $18.13 | 117526 | D |  |
| Class A Common Stock | 2023-03-08 |  | F |  | 8282<sup>(4)</sup> | D | $18.35 | 109244 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) Represents shares of Class A Common Stock underlying a restricted stock unit award that vests as to 1/3 of the shares on each of March 7, 2024, March 7, 2025, and March 7, 2026, subject to the reporting person's provision of services to the issuer on each vesting date.

(2) Represents shares of Class A Common Stock underlying a performance-based restricted stock unit award granted on January 29, 2021. 25% of the award vested on March 7, 2023 and the remaining 75% will vest ratably over the next three years on December 15, 2023, December 15, 2024, and December 15, 2025, subject to the reporting person's provision of service to the issuer on each vesting date.

(3) Represents shares of Class A Common Stock that have been withheld by the issuer to satisfy its income tax withholding and remittance obligations in connection with the net settlement of the PRSUs, based on a price of $18.13 per share, which represented the closing price of the issuer's Class A Common Stock on March 7, 2023, and does not represent a sale by the reporting person.

(4) Represents shares of Class A Common Stock that have been withheld by the issuer to satisfy its income tax withholding and remittance obligations in connection with the net settlement of the RSUs, based on a price of $18.35 per share, which represented the closing price of the issuer's Class A Common Stock on March 8, 2023, and does not represent a sale by the reporting person.

**Signature:** /s/ Kristen Juhan as attorney-in-fact for Amit Parikh  
**Date:** 2023-03-09

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**