0001261163-18-000010.txt : 20180802
0001261163-18-000010.hdr.sgml : 20180802
20180802162458
ACCESSION NUMBER: 0001261163-18-000010
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180731
FILED AS OF DATE: 20180802
DATE AS OF CHANGE: 20180802
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BUSBEE JEFF
CENTRAL INDEX KEY: 0001261163
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38257
FILM NUMBER: 18988716
MAIL ADDRESS:
STREET 1: 296 GRAYSON HIGHWAY
CITY: LAWRENCEVILLE
STATE: GA
ZIP: 30048
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: National Vision Holdings, Inc.
CENTRAL INDEX KEY: 0001710155
STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851]
IRS NUMBER: 464841717
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1230
BUSINESS ADDRESS:
STREET 1: 2435 COMMERCE AVENUE
STREET 2: BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096-4980
BUSINESS PHONE: (770) 822-3600
MAIL ADDRESS:
STREET 1: 2435 COMMERCE AVENUE
STREET 2: BLDG. 2200
CITY: DULUTH
STATE: GA
ZIP: 30096-4980
4
1
wf-form4_153324148252778.xml
FORM 4
X0306
4
2018-07-31
0
0001710155
National Vision Holdings, Inc.
EYE
0001261163
BUSBEE JEFF
C/O NATIONAL VISION HOLDINGS, INC.,
2435 COMMERCE AVENUE, BLDG. 2200
DULUTH
GA
30096-4980
0
1
0
0
SVP, Chief HR Officer
Common Stock
2018-07-31
4
M
0
6782
4.27
A
72625
D
Common Stock
2018-08-02
4
S
0
6782
38.2594
D
65843
D
Stock Option (Right to Buy)
4.27
2018-08-02
4
A
0
8239
4.27
A
2024-03-13
Common Stock
8239.0
107308
D
Stock Option (Right to Buy)
4.27
2018-07-31
4
M
0
6782
4.27
D
2024-03-13
Common Stock
6782.0
100526
D
This amount represents the secondary public offering price per share of common stock of National Vision Holdings, Inc., less the underwriting discount of $1.4906 per share, in connection with the exercise of the underwriters' over-allotment option.
On March 13, 2014, the reporting person was granted stock options, subject to time-based and performance-based vesting. On August 2, 2018, a liquidity event with respect to such performance-based stock options occurred as a result of sales by the Issuer's sponsor stockholders and 8,239 stock options which had previously not been reported were deemed earned.
Of the 100,526 stock options reported herein, 78,556 are vested and the remaining 21,970 time-based stock options will vest on March 13, 2019. An additional 98,867 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above.
/s/ Jared Brandman, as Attorney-in-Fact
2018-08-02