0001179110-21-005534.txt : 20210518 0001179110-21-005534.hdr.sgml : 20210518 20210518184359 ACCESSION NUMBER: 0001179110-21-005534 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210514 FILED AS OF DATE: 20210518 DATE AS OF CHANGE: 20210518 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: 21937767 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: 0327 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 edgar.xml FORM 4 - X0306 4 2021-05-14 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 2021-05-14 4 A 0 1277 0 A 4859 D Common Stock 6526 D Consists of shares underlying restricted stock units granted under the Company's 2020 Equity Incentive Plan, subject to vesting on the first anniversary of the date of grant. Consists of the total number of shares of common stock underlying restricted stock units held by the reporting person as of May 14, 2021 that remain subject to time-based vesting. Amount of securities beneficially owned consists of the number of shares of common stock held by the reporting person as of May 14, 2021. Amount includes 2,620 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 conditions. /s/ Anne MacDonald 2021-05-18