0001261163-18-000014.txt : 20180926
0001261163-18-000014.hdr.sgml : 20180926
20180926174535
ACCESSION NUMBER: 0001261163-18-000014
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180924
FILED AS OF DATE: 20180926
DATE AS OF CHANGE: 20180926
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: 181088765
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_153799825147832.xml
FORM 4
X0306
4
2018-09-24
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
2018-09-24
4
M
0
36771
4.27
A
98864
D
Common Stock
2018-09-24
4
S
0
36771
42.40
D
62093
D
Stock Option (Right to Buy)
4.27
2018-09-24
4
M
0
36771
4.27
D
2024-03-13
Common Stock
36771.0
63755
D
The sale reported on this Form 4 was effected pursuant to a Rule 10b5-1 trading plan established by the reporting person on August 23, 2018
Of these 100,526 stock options, 78,556 are vested and the remaining 21,970 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
2018-09-26