Green Dot Corporation |
(Name of Issuer) |
Class A Common Stock, par value $0.001 per share |
(Title of Class of Securities) |
39304D 102 |
(CUSIP Number) |
December 31, 2011 |
(Date of Event Which Requires Filing of this Statement) |
CUSIP No. 39304D 102 | Page 2 of 5 Pages |
1 | NAME OF REPORTING PERSON Mark T. Troughton | ||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions) (a) £ (b) £ | ||
3 | SEC USE ONLY | ||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION U.S. | ||
NUMBER OF | 5 | SOLE VOTING POWER 1,130,270 shares (1)(2) | |
SHARES BENEFICIALLY OWNED | 6 | SHARED VOTING POWER 126,250 shares (2)(3) | |
BY EACH REPORTING | 7 | SOLE DISPOSITIVE POWER 1,130,270 shares (1)(2) | |
PERSON WITH | 8 | SHARED DISPOSITIVE POWER 126,250 shares (2)(3) | |
9 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,256,520 shares (1)(2)(3) | ||
10 | CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (See Instructions) £ | ||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 4.0% * | ||
12 | TYPE OF REPORTING PERSON (See Instructions) IN |
(1) | Represents 68,755 shares of Class A common stock held by the Reporting Person, 57,633 shares of Class B common stock held by the Mark Troughton GRAT DTD 6/22/10, for which the Reporting Person is trustee, 448,249 shares of Class B common stock held by the Reporting Person and 555,633 shares of Class B common stock subject to options held by the Reporting Person that are exercisable within 60 days of December 31, 2011. |
(2) | The Class B common stock of the Issuer is convertible at the holder's option into the Issuer's Class A common stock on a 1-for-1 basis. |
(3) | Represents 57,633 shares of Class B common stock held by the Tara McWhirter GRAT DTD 6/22/2010, for which the Reporting Person's spouse is the trustee, and 68,617 shares of Class A common stock held by the Reporting Person's spouse. |
* | Based on 30,161,742 shares of Class A common stock outstanding as of December 31, 2011, as reported by the Issuer to the Reporting Person, plus the number of shares of Class B common stock held by the Reporting Person or affiliates of the Reporting Person, which are treated as outstanding only for the purpose of computing the percentage ownership of the Reporting Person. |
CUSIP No. 39304D 102 | Page 3 of 5 Pages |
Item 1. | |||
(a) | Name of Issuer: | ||
Green Dot Corporation (the "Issuer") | |||
(b) | Address of Issuer's Principal Executive Offices: | ||
605 East Huntington Drive, Suite 205 Monrovia, CA 91016 | |||
Item 2. | |||
(a) | Name of Person Filing: | ||
Mark T. Troughton (the “Reporting Person”) | |||
(b) | Address of Principal Business Office: | ||
c/o Green Dot Corporation 605 East Huntington Drive, Suite 205 Monrovia, CA 91016 | |||
(c) | Citizenship: | ||
U.S. | |||
(d) | Title of Class of Securities: | ||
Class A Common Stock, par value $0.001 per share | |||
(e) | CUSIP Number: | ||
39304D 102 | |||
Item 3. | Not applicable | ||
Item 4. | Ownership | ||
The following information with respect to the ownership of the Class A Common Stock of the Issuer by the Reporting Person is provided as of December 31, 2011: | |||
(a) | Amount beneficially owned: | ||
See Row 9 of cover page for the Reporting Person | |||
(b) | Percent of class: | ||
See Row 11 of cover page for the Reporting Person |
CUSIP No. 39304D 102 | Page 4 of 5 Pages |
(c) | Number of shares as to which the person has: | ||
(i) | Sole power to vote or to direct the vote: | ||
See Row 5 of cover page for the Reporting Person | |||
(ii) | Shared power to vote or to direct the vote: | ||
See Row 6 of cover page for the Reporting Person | |||
(iii) | Sole power to dispose or to direct the disposition of: | ||
See Row 7 of cover page for the Reporting Person | |||
(iv) | Shared power to dispose or to direct the disposition of: | ||
See Row 8 of cover page for the Reporting Person | |||
Item 5. | Ownership of Five Percent or Less of a Class | ||
If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following: R | |||
Item 6. | Ownership of More than Five Percent on Behalf of Another Person | ||
Not applicable | |||
Item 7. | Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company | ||
Not applicable | |||
Item 8. | Identification and Classification of Members of the Group | ||
Not applicable | |||
Item 9. | Identification and Classification of Members of the Group | ||
Not applicable | |||
Item 10. | Certification | ||
Not applicable |
CUSIP No. 39304D 102 | Page 5 of 5 Pages |
Dated: | February 14, 2012 | /s/ Mark T. Troughton | ||
Name: | Mark T. Troughton |