SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF 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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1. Name and Address of Reporting Person*
Kapp William E

(Last) (First) (Middle)
30 FRANK LLOYD WRIGHT DRIVE

(Street)
ANN ARBOR MI 48106

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/14/2007
3. Issuer Name and Ticker or Trading Symbol
DOMINOS PIZZA INC [ DPZ ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, $.01 par value 848.426(1) I Held in 401(k) Stock Fund
Common Stock, $.01 par value 1,163.089(2) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option to purchase Common Stock 05/04/2007(3) 07/01/2013 Common Stock, $.01 par value 11,666 $8.66 D
Option to purchase Common Stock 07/13/2009(4) 07/13/2014 Common Stock, $.01 par value 3,200 $2.75(8) D
Option to purchase Common Stock 07/13/2009(4) 07/13/2014 Common Stock, $.01 par value 4,800 $14 D
Option to purchase Common Stock 07/29/2010(5) 07/29/2015 Common Stock, $.01 par value 3,000 $11.52(8) D
Option to purchase Common Stock 07/29/2010(5) 07/29/2015 Common Stock, $.01 par value 2,000 $25.02 D
Option to purchase Common Stock 07/26/2011(6) 07/26/2016 Common Stock, $.01 par value 6,400 $8.96(8) D
Option to purchase Common Stock 07/26/2011(6) 07/26/2016 Common Stock, $.01 par value 1,600 $22.46 D
Option to purchase Common Stock 07/18/2012(7) 07/18/2017 Common Stock, $.01 par value 15,000 $18.39 D
Explanation of Responses:
1. Total shares held in Domino's Pizza, Inc. stock fund, part of the Domino's Pizza 401(k) savings plan.
2. Total shares acquired through Employee Stock Payroll Deduction Plan.
3. The vesting schedule for the options to purchase common stock was accelerated to be fully exercisable on May 4, 2007 in connection with the Domino's Pizza, Inc. recapitalization. No new options to purchase common stock were granted.
4. The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% vested on each of July 13, 2005, July 13, 2006 and July 13, 2007 and an additional 20% shall vest on each of July 13, 2008 and July 13, 2009.
5. The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% vested on each of July 29, 2006,and July 29, 2007 and an additional 20% shall vest on each of July 29, 2008, July 29, 2009 and July 29, 2010.
6. The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% vested on July 26, 2007 and an additional 20% shall vest on each of July 13, 2008, July 13, 2009, July 13, 2010 and July 13, 2011.
7. The options to purchase common stock vest 20% each year on the anniversary of the option to purchase grant date. Thus 20% shall vest on each of July 18, 2008, July 18, 2009, July 18, 2010, July 13, 2011 and July 13, 2012.
8. Reflects adjustment to previously granted stock option awards under the Domino's Pizza, Inc. 2004 Equity Incentive Plan in connection with the special dividend of $13.50 per share of Common Stock of Domino's Pizza, Inc. payable on May 4, 2007 to shareholders of record on April 27, 2007. The exercise price of the stock options was adjusted by the amount of the dividend, or by such lesser amount required by law.
/s/ William E. Kapp 09/17/2007
** Signature of Reporting Person Date
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 5 (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.
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