0001104659-21-140161.txt : 20211116 0001104659-21-140161.hdr.sgml : 20211116 20211116195650 ACCESSION NUMBER: 0001104659-21-140161 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211115 FILED AS OF DATE: 20211116 DATE AS OF CHANGE: 20211116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MACDONALD ANNE CENTRAL INDEX KEY: 0001240498 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36711 FILM NUMBER: 211417969 MAIL ADDRESS: STREET 1: 200 CARILLON PARKWAY CITY: ST PETERSBURG STATE: FL ZIP: 33716 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Boot Barn Holdings, Inc. CENTRAL INDEX KEY: 0001610250 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-SHOE STORES [5661] IRS NUMBER: 900776290 STATE OF INCORPORATION: DE FISCAL YEAR END: 0326 BUSINESS ADDRESS: STREET 1: 15345 BARRANCA PARKWAY CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-453-4400 MAIL ADDRESS: STREET 1: 15345 BARRANCA PARKWAY CITY: IRVINE STATE: CA ZIP: 92618 4 1 tm2133085-2_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-11-15 0 0001610250 Boot Barn Holdings, Inc. BOOT 0001240498 MACDONALD ANNE C/O BOOT BARN HOLDINGS, INC. 15345 BARRANCA PKWY IRVINE CA 92618 1 0 0 0 Common Stock 2021-11-15 4 S 0 300 120.1800 D 9808 D Common Stock 2021-11-15 4 S 0 675 120.0927 D 9133 D Common Stock 2021-11-16 4 S 0 975 125.00 D 8158 D Common Stock 1277 D Amount of securities beneficially owned consists of the number of shares of common stock held by the reporting person as of November 16, 2021. The amount includes 6,202 shares underlying restricted stock units for which the vesting criteria have been satisfied but the delivery of such shares has been deferred, but excludes any shares of common stock subject to further vesting. Consists of the total number of shares of common stock underlying restricted stock units held by the reporting person as of November 16, 2021, that remain subject to time-based vesting. /s/ Anne MacDonald 2021-11-16