0001181070-18-000012.txt : 20181116
0001181070-18-000012.hdr.sgml : 20181116
20181116161226
ACCESSION NUMBER: 0001181070-18-000012
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181114
FILED AS OF DATE: 20181116
DATE AS OF CHANGE: 20181116
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GOODMAN MITCHELL
CENTRAL INDEX KEY: 0001181070
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38257
FILM NUMBER: 181189971
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: National Vision Holdings, Inc.
CENTRAL INDEX KEY: 0001710155
STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851]
IRS NUMBER: 464841717
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1230
BUSINESS ADDRESS:
STREET 1: 2435 COMMERCE AVENUE
STREET 2: BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096-4980
BUSINESS PHONE: (770) 822-3600
MAIL ADDRESS:
STREET 1: 2435 COMMERCE AVENUE
STREET 2: BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096-4980
4
1
wf-form4_154240272955503.xml
FORM 4
X0306
4
2018-11-14
0
0001710155
National Vision Holdings, Inc.
EYE
0001181070
GOODMAN MITCHELL
C/O NATIONAL VISION HOLDINGS, INC.,
2435 COMMERCE AVENUE, BLDG. 2200
DULUTH
GA
30096-4980
0
1
0
0
SVP, GC and Secretary
Common Stock
2018-11-14
4
M
0
85440
4.27
A
139380
D
Common Stock
2018-11-14
4
M
0
9136
7.25
A
148516
D
Stock Option (Right to Buy)
4.27
2018-11-14
4
M
0
85440
4.27
D
2024-03-13
Common Stock
85440.0
28480
D
Stock Option (Right to Buy)
7.25
2018-11-14
4
M
0
9136
7.25
D
2024-03-13
Common Stock
9136.0
3650
D
Represents an exercise of stock options in connection with the Reporting Person's sale of shares of common stock received upon exercise in a secondary offering that is scheduled to be completed on November 19, 2018.
The remaining 28,480 stock options will vest on March 13, 2019. An additional 128,162 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above.
These stock options are fully vested.
/s/ Jared Brandman, as Attorney-in-Fact
2018-11-16