0001261163-19-000004.txt : 20190530
0001261163-19-000004.hdr.sgml : 20190530
20190530163020
ACCESSION NUMBER: 0001261163-19-000004
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190528
FILED AS OF DATE: 20190530
DATE AS OF CHANGE: 20190530
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: 19866917
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: 1229
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_155924820448126.xml
FORM 4
X0306
4
2019-05-28
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
2019-05-28
4
M
0
29980
4.27
A
92073
D
Common Stock
2019-05-28
4
S
0
29980
29.017
D
62093
D
Common Stock
2019-05-29
4
M
0
20764
4.27
A
82857
D
Common Stock
2019-05-28
4
S
0
20764
28
D
62093
D
Stock Option (Right to Buy)
4.27
2019-05-28
4
M
0
29980
0
D
2024-03-13
Common Stock
29980.0
70850
D
Stock Option (Right to Buy)
4.27
2019-05-29
4
M
0
20764
0
D
2024-03-13
Common Stock
20764.0
50086
D
Price represents the weighted average sales price. The shares were sold pursuant to a single order in multiple transactions as prices ranging from $29.00 to $29.09. Upon request by the SEC staff, the issuer or a security holder of the issuer, the reporting person will provide full information regarding the number of shares sold at each separate price.
Of these 70,850 stock options, all are vested. An additional 61,792 stock options which remain subject to liquidity-event performance-based vesting conditions are not included in the table above.
Of these 50,086 stock options, all are vested. 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
2019-05-30