0001181253-21-000014.txt : 20211116 0001181253-21-000014.hdr.sgml : 20211116 20211116163257 ACCESSION NUMBER: 0001181253-21-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211112 FILED AS OF DATE: 20211116 DATE AS OF CHANGE: 20211116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FAHS L READE CENTRAL INDEX KEY: 0001181253 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 211416566 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: 0101 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_163709796291446.xml FORM 4 X0306 4 2021-11-12 0 0001710155 National Vision Holdings, Inc. EYE 0001181253 FAHS L READE C/O NATIONAL VISION HOLDINGS, INC., 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096-4980 1 1 0 0 Chief Executive Officer Common Stock 2021-11-12 4 G 0 160000 0 D 452508 D Common Stock 2021-11-12 4 G 0 160000 0 A 343430 I Held by Trust On November 12, 2021, the reporting person transferred 160,000 shares of common stock to a family trust. The reporting person's spouse is trustee of the trust. /s/ Jared Brandman, as Attorney-in-Fact 2021-11-16