0001209191-16-102937.txt : 20160226
0001209191-16-102937.hdr.sgml : 20160226
20160226163802
ACCESSION NUMBER: 0001209191-16-102937
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160224
FILED AS OF DATE: 20160226
DATE AS OF CHANGE: 20160226
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BALSON ANDREW
CENTRAL INDEX KEY: 0001212449
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32242
FILM NUMBER: 161462534
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-02-24
0
0001286681
DOMINOS PIZZA INC
DPZ
0001212449
BALSON ANDREW
C/O DOMINO'S PIZZA
30 FRANK LLOYD WRIGHT DRIVE
ANN ARBOR
MI
48105
1
0
0
0
Common Stock, $0.01 par value
2016-02-24
4
A
0
940
0.00
A
20643
D
Common Stock, $0.01 par value
27310
I
Andrew B. Balson 2004 Irrevocable Family Trust
Common Stock, $0.01 par value
8870
I
Andrew B. Balson 2011 Irrevocable Family Trust
The shares of common stock represent a grant of restricted stock that shall vest 100% on the first anniversary of the issuance date. Thus, all shares shall vest on February 24, 2017.
/s/ Adam J. Gacek, attorney-in-fact
2016-02-26