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