0001261163-18-000016.txt : 20181121
0001261163-18-000016.hdr.sgml : 20181121
20181121162218
ACCESSION NUMBER: 0001261163-18-000016
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181119
FILED AS OF DATE: 20181121
DATE AS OF CHANGE: 20181121
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: 181198439
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_154283531748114.xml
FORM 4
X0306
4
2018-11-19
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
Stock Option (Right to Buy)
4.27
2018-11-19
4
A
0
37075
4.27
A
2024-03-13
Common Stock
37075.0
100830
D
On March 13, 2014, the reporting person was granted stock options, subject to time-based and performance-based vesting. On November 19, 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 37,075 stock options which had previously not been reported were deemed earned.
Of these 100,830 stock options, 78,860 are vested and the remaining 21,970 stock options will vest on March 13, 2019. An additional 61,792 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
2018-11-21