0001277322-23-000004.txt : 20230616 0001277322-23-000004.hdr.sgml : 20230616 20230616162927 ACCESSION NUMBER: 0001277322-23-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230614 FILED AS OF DATE: 20230616 DATE AS OF CHANGE: 20230616 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TAYLOR THOMAS V CENTRAL INDEX KEY: 0001277322 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38257 FILM NUMBER: 231021610 MAIL ADDRESS: STREET 1: 2233 LAKE PARK DRIVE STREET 2: STE. 400 CITY: SMYRNA STATE: GA ZIP: 30080 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 wk-form4_1686947352.xml FORM 4 X0407 4 2023-06-14 0 0001710155 National Vision Holdings, Inc. EYE 0001277322 TAYLOR THOMAS V C/O NATIONAL VISION HOLDINGS, INC. 2435 COMMERCE AVENUE, BLDG. 2200 DULUTH GA 30096-4980 1 0 0 0 0 Common Stock 2023-06-14 4 A 0 9127 0 A 34683 D Represents a restricted stock unit ("RSU") grant pursuant to NVHI's non-employee director compensation policy. The RSUs vest in full on the one year anniversary of the date of grant, subject to the Reporting Person's continuous service through such vesting date. Each RSU represents a contingent right to receive one share of NVHI common stock. /s/ Jared Brandman, as Attorney-in-Fact 2023-06-16