0001771515-24-000116.txt : 20240605
0001771515-24-000116.hdr.sgml : 20240605
20240605171932
ACCESSION NUMBER: 0001771515-24-000116
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240603
FILED AS OF DATE: 20240605
DATE AS OF CHANGE: 20240605
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Herman Thomas F
CENTRAL INDEX KEY: 0001253547
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38950
FILM NUMBER: 241023033
MAIL ADDRESS:
STREET 1: C/O GROCERY OUTLET HOLDING CORP.
STREET 2: 5650 HOLLIS STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
FORMER NAME:
FORMER CONFORMED NAME: HERMAN THOMAS F
DATE OF NAME CHANGE: 20030711
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Grocery Outlet Holding Corp.
CENTRAL INDEX KEY: 0001771515
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411]
ORGANIZATION NAME: 07 Trade & Services
IRS NUMBER: 471874201
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1228
BUSINESS ADDRESS:
STREET 1: 5650 HOLLIS STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: (510) 845-1999
MAIL ADDRESS:
STREET 1: 5650 HOLLIS STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
4
1
wk-form4_1717622364.xml
FORM 4
X0508
4
2024-06-03
0
0001771515
Grocery Outlet Holding Corp.
GO
0001253547
Herman Thomas F
C/O GROCERY OUTLET HOLDING CORP.
5650 HOLLIS STREET
EMERYVILLE
CA
94608
1
0
0
0
0
Common Stock
2024-06-03
4
A
0
6803
0
A
12640
D
Common Stock
14553
I
By Trust
Represents 6,803 restricted stock units ("RSUs") granted to the reporting person which are scheduled to vest on the earlier of (i) the date of the next annual meeting of stockholders following the date of grant; or (ii) June 3, 2025, subject to the continued service of the reporting person through such vesting date. The RSUs represent the annual equity retainer under the Issuer's non-employee director compensation policy.
Reflects shares directly held by the Thomas F. Herman Separate Property Trust of which Mr. Herman is a Trustee.
/s/ Lauri Fischer, Lauri Fischer, attorney-in-fact
2024-06-05