0001209191-18-009574.txt : 20180213
0001209191-18-009574.hdr.sgml : 20180213
20180213164415
ACCESSION NUMBER: 0001209191-18-009574
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171231
FILED AS OF DATE: 20180213
DATE AS OF CHANGE: 20180213
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GOLDMAN JAMES A
CENTRAL INDEX KEY: 0001194070
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32242
FILM NUMBER: 18604154
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: DOMINOS PIZZA INC
CENTRAL INDEX KEY: 0001286681
STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-GROCERIES & RELATED PRODUCTS [5140]
IRS NUMBER: 382511577
BUSINESS ADDRESS:
STREET 1: 30 FRANK LLOYD WRIGHT DRIVE
CITY: ANN ARBOR
STATE: MI
ZIP: 48106
MAIL ADDRESS:
STREET 1: 30 FRANK LLOYD WRIGHT DRIVE
CITY: ANN ARBOR
STATE: MI
ZIP: 48106
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2017-12-31
0
0
0
0001286681
DOMINOS PIZZA INC
DPZ
0001194070
GOLDMAN JAMES A
DOMINO'S PIZZA
30 FRANK LLOYD WRIGHT DRIVE
ANN ARBOR
MI
48105
1
0
0
0
Common Stock, $0.01 par value
2017-11-29
5
G
0
66
0.00
D
9698
D
Common Stock, $0.01 par value
2017-11-30
5
G
0
1050
0.00
D
8648
D
Common Stock, $0.01 par value
2017-12-01
5
G
0
803
0.00
D
7845
D
This transaction involved a gift of common stock of Domino's Pizza, Inc. by Mr. Goldman to charity. The transaction is exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended (the "Act"), pursuant to Rule 16b-5 of the Act.
/s/ Adam J. Gacek, attorney-in-fact
2018-02-13