SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Palella Salvatore

(Last) (First) (Middle)
C/O HELBIZ, INC., 32 OLD SLIP,
32ND FLOOR

(Street)
NEW YORK NY 10005

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Helbiz, Inc. [ HLBZ HLBZW ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
08/12/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock (Class A) 03/08/2022 P 50,000 A $3.05 550,000 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options $2.16 08/12/2021(1) A 1,484,721 (2) 04/01/2030 Class A Common Stock 1,484,721 $3.05 1,484,721 D(1)
Performance Based Restricted $0.00(3) 08/12/2021 A 600,000 (4) 04/01/2030 Class A Common Shares 600,000 $3.05 600,000 D
Explanation of Responses:
1. Granted by Helbiz Holdings Inc., under the 2020 Equity Incentive Plan adopted on April 1, 2020. Upon the merger by and among Green Vision Acquisition Corp., Helbiz Holdings Inc., and Green Vision Merge Sub Inc. on August 12, 2021, the options were exchanged for options of Helbiz, Inc., the successor to GreenVision Acquisition Corp.
2. 50% of the options vest on the one-year anniversary of the 2020 Equity Incentive Plan. The remaining stock options vest at a rate of 1.4% a month over the next 36 months. As of the date of this filing 969,244 Stock Options have vest.
3. Granted by Helbiz Holdings Inc. under the 2020 CEO Performance Plan adopted on April 1,2020. Upon the merger by and among GreenVision Acquisition Corp., Helbiz Holdings Inc., and GreenVision Merger Sub Inc. on August 12,2021, the performance-based restricted shares were exchanged for performance-based restricted shares of Helbiz Inc., the successor to GreenVision Acquisition Corp.
4. The vesting of these performance-based restricted shares is subject to the attainment of certain performance objectives between 4/1/2020 and 4/1/2030 (the "2020-2030 Performance Period"). The target number (100%) of the total performance-based restricted shares is reported in the table set forth above. The portion of the target number of performance-based restricted shares allocated to each applicable performance objective will vest upon the attainment of the applicable performance objective.
/s/ Salvatore Palella 03/11/2022
** Signature of Reporting Person Date
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* 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).
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