0001209191-17-043364.txt : 20170705 0001209191-17-043364.hdr.sgml : 20170705 20170705162736 ACCESSION NUMBER: 0001209191-17-043364 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170630 FILED AS OF DATE: 20170705 DATE AS OF CHANGE: 20170705 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HENRY SCHEIN INC CENTRAL INDEX KEY: 0001000228 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 113136595 STATE OF INCORPORATION: DE FISCAL YEAR END: 1229 BUSINESS ADDRESS: STREET 1: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 BUSINESS PHONE: 6318435500 MAIL ADDRESS: STREET 1: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 FORMER COMPANY: FORMER CONFORMED NAME: SCHEIN HENRY INC DATE OF NAME CHANGE: 19950907 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rekow E Dianne CENTRAL INDEX KEY: 0001609814 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 17948480 MAIL ADDRESS: STREET 1: C/O HENRY SCHEIN, INC. STREET 2: 135 DURYEA ROAD CITY: MELVILLE STATE: NY ZIP: 11787 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-06-30 0 0001000228 HENRY SCHEIN INC HSIC 0001609814 Rekow E Dianne C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 1 0 0 0 Common Stock, par value $0.01 per share 5274 D Deferred Compensation Plan Phantom Stock 2017-06-30 4 A 0 132 0.00 A Common Stock, par value $0.01 per share 132 1520 D Each share of phantom stock is the economic equivalent of one share of the Issuer's common stock. Represents the number of shares of phantom stock credited to the reporting person's phantom stock account pursuant to the Issuer's Non-Employee Director Deferred Compensation Plan (the "Plan"), representing an exempt transaction under the Plan. The number of shares of phantom stock credited to the reporting person's phantom stock account is determined by dividing the amount of deferred eligible director fees by the closing price of a share of Issuer common stock on the award date. The balance in the reporting person's phantom share account is distributed to the reporting person in Issuer common stock following the termination of the reporting person's directorship, the reporting person's death or disability or a change of control of the Issuer. Represents the aggregate number of shares of phantom stock allocated to the reporting person under the Plan as of the award date based on the closing price of a share of the Issuer's common stock on the award date. /s/ Jennifer Ferrero (as Attorney-in-Fact for E. Dianne Rekow, DDS, Ph.D.) 2017-07-05